Caring Dads Theory Manual May 2010
Caring Dads Theory Manual
By: Katreena Scott
Caring Dads Theory May 2010
1
Caring Dads Theory Manual May 2010
Table of Contents
1. Introduction
2. Section 1: Why fathers are an essential target of intervention to end children’s
experiences of violence and abuse within the home
a. Incidence and impact of child maltreatment
b. Father-perpetrated maltreatment
c. Potential benefits of intervening with fathers
d. Summary
3. Section 2: What do we know about the systems necessary to help keep children safe
from maltreatment from their fathers?
a. Involvement and engagement in intervention
b. Compliance with intervention
c. Coordinated Case Management in Response to Unchanging or Rising Risk
d. Keeping the child in focus
e. Appreciating the overlap between child maltreatment and domestic violence
f. Summary
4. Section 3: What do we know about promising individual treatment outcomes necessary
to help keep children safe from abuse from their fathers?
a. Anger/hostility/over-reactivity
b. Domestic violence/family cohesion
c. Perceptions of the child as a problem
d. Use of corporal punishment and other aversive behaviours
e. Quality of parent-child relationships
f. Self-centeredness
g. Misuse of Substances
h. Summary
5. Section 4: Caring Dads: Helping Fathers Value their Children Program Model Overview
a. Program history
b. Overview of the Caring Dads group intervention for fathers
c. Module 1, Sessions 1-3: To develop sufficient trust and motivation to engage
men in the process of examining their fathering
d. Module 2, Sessions 4-9: To increase men's awareness and application of childcentered fathering
e. Module 3, Sessions 10-15: To Increase men's awareness of, and responsibility
for, abusive and neglectful fathering and its impact on children
f. Module 4, Sessions 16 and 17: Rebuilding trust with children and planning for the
future.
6. Section 5: Caring Dads Mother Contact
a. Complicating aspects of mother contact
7. Section 6: Caring Dads Coordinated Case Management
a. Coordinated case management to ensure that priority is given to the safety and
well-being of children and that Caring Dads is responsive to rising levels of risk
b. Coordinated case management to ensure the safety of children’s mothers
c. Coordinated case management to ensure that fathers are engaged in
intervention and compliant with basic treatment demands (i.e., attending,
participating)
d. Coordinated case management to ensure that the child is kept in focus
8. Conclusion
9. References
Caring Dads Theory May 2010
2
Caring Dads Theory Manual May 2010
INTRODUCTION
This manual describes the theory behind the Caring Dads: Helping Fathers Value their Children
program for fathers who have maltreated their children, exposed them to abuse of their mother,
or are at high-risk for these behaviours. The rationale for developing and offering a program
such as Caring Dads is first reviewed. Following this, we consider the empirical evidence in
support promising treatment targets and outline the principles that guide Caring Dads
implementation. Subsequent sections provide a more detailed discussion of the therapeutic
techniques used and review essential details of program implementation. This manual should
be read in conjunction with the manuals detailing the programme content, training, case
management, assessment, evaluation, and mother contact.
SECTION 1: WHY FATHERS ARE AN ESSENTIAL TARGET OF INTERVENTION TO END
CHILDREN’S EXPERIENCES OF VIOLENCE AND ABUSE WITHIN THE HOME
A. Incidence and Impact of Child Maltreatment
Children’s experience of violence in their home is a critically important public health and
human rights issue worldwide. In 2002, the World Health Organization published the first
comprehensive global summary of the problem of family violence, concluding that child
maltreatment is a substantial global problem (Krug et al., 2002). A follow-up report by the
Secretary General for the United Nations in 2006 highlighted the high global incidence of familyperpetrated physical violence, deliberate neglect, child sexual abuse and homicide. National
incidence studies of child maltreatment in developed nations and retrospective surveys of adults
confirm high rates abuse. A major nationally representative NSPCC survey in 2000 found that,
in the UK, serious maltreatment was experienced by 7% of respondents for physical abuse, 6%
for emotional abuse, 6% for absence of care, 5% for absence of supervision, and 11% for
sexual abuse involving contact. Rates are higher when intermediate maltreatment and
behaviours that lead to a cause for concern are included, rising to 24% for physical abuse, 17%
for absence of care, 20% for absence of supervision, and up to 34% for varying forms of
emotional maltreatment. A small proportion of these maltreated children come under the
protection of social care agencies. Between 2006 and 2007, 27,900 children were subject to a
Child Protection Plan (25.2 per 10,000) in the UK and in the following year, there were 281
serious incidents recorded, relating to 189 deaths and 87 incidents of significant harm or injuries
(Safeguarding Children, 2008).
Maltreatment has substantial implications for the children’s health and well-being. Child
abuse and neglect interfere with healthy child development and contribute to a range of
negative psychological and physical health outcomes (MacMillian & Munn, 2001; Wekerle &
Wolfe, 2003). Children who experience abuse and/or who are exposed to abuse of their mother
are more likely to be diagnosed with a psychological disorder and to show difficulties with early
attachment, emotional regulation, peer relationships, school adjustment, and pro-social
behaviours (Evans, Davies & DiLillo, 2008; Kitzmann, Gavlord, Holt & Kenny, 2003; Wekerle &
Wolfe, 2003; Wolfe, Crooks, Lee, McIntyre & Jaffe, 2003). During adolescence, child
maltreatment raises the risk of numerous health-risk behaviours including smoking, substance
use, early and promiscuous sexuality and substantially increases the risk for delinquency
(Crooks et al., 2007; Wolfe et al., 2001). Child maltreatment and associated adverse childhood
experiences also show a graded relationship to the presence of adult diseases including
ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease
(Felitti et al., 1998). Not surprisingly then, self-reported history of maltreatment is associated
with significant and sustained losses in health-related quality of life (Afifi et al., 2007; Corso,
Edwards, Fang & Mercy, 2008) and with premature mortality (Anda et al., 2009). There are also
substantial economic costs associated with child maltreatment. In 1996, the National
Caring Dads Theory May 2010
3
Caring Dads Theory Manual May 2010
Commission of Inquiry into the Prevention of Child Abuse estimated that the cost of child abuse
to statutory and voluntary agencies in the UK was £1 billion per year.
B. Father-perpetrated Maltreatment
Although child maltreatment constitutes a significant problem in general, fatherperpetrated child maltreatment deserves particular attention. In the UK, detailed data on the
alleged perpetrator of maltreatment is seldom available. However, data from other developed
nations suggest that fathers are at least as likely as mothers to maltreat their children. The
second national Canadian Incidence Study of Reported Child Abuse shows that 60% of
maltreatment substantiated by child protection agencies across Canada involved fathers
(biological, stepmothers/common-law partners) and 56% involved mothers (numbers sum to
over 100% because maltreatment can be substantiated against both parents). The prevalence
of father-perpetrated maltreatment is even more apparent when single parent families (which
make up 43% of families investigated) are excluded. Among children living in two-parent
families, fathers are perpetrators in the majority of substantiated cases of physical abuse (67%),
emotional abuse (56%) and exposure to domestic violence (88%) (Trocme et al., 2005). The
prevalence of fathers as perpetrators of child maltreatment is also echoed in population surveys
across North America (e.g., Straus & Gelles, 1990). The limited data available on maltreatment
perpetration in the UK suggests that patterns may be similar. The NSPCC National survey
(1996) reported that fathers were consistently less likely to be seen as offering closeness,
support and good role models than were mothers, and a fifth of the sample reported being
‘sometimes really afraid’ of their fathers. NSPCC also reported that, in cases of physical abuse
across single and two-parent families, mothers were identified as perpetrators 49% of the time
and fathers 40% of the time.
In addition to frequency of father-perpetrated child maltreatment, data from many nations
converge on the finding that fathers predominate as perpetrators of injury-causing and fatal child
abuse (Brewster et al., 1998; Klevens et al., 2000). Canadian homicide data across 30 years
consistently show that the majority of family-related child homicides are committed by fathers
(Canadian Centre for Justice Statistics, 2006). Step-fathers, in particular, are proportionally
over-represented as perpetrators of maltreatment and of child homicide (Daly & Wilson, 2000;
Radhakrishna, Bou-Saada, Hunter, Catellier, & Kotch, 2001). Fathers are also more likely to be
identified and substantiated for moderate-to-severe abuse and for repeated abuse incidents
(Pittman & Buckley, 2006). In the US, these data on the frequency and severity of fatherperpetrated maltreatment have led to the conclusion that “if prevention and treatment
interventions for child maltreatment are targeted only to women, a large proportion of
perpetrators will not benefit from these efforts.” (p. iv, US Department of Health and Human
Services, 2005).
A third reason it is essential to address violent fathers is their impact on effectiveness of
intervention for other family members. There is emerging evidence to suggest that, when
fathers’ violence is unaddressed, intervention with children’s mothers is less effective. For
example, using data from a large randomized control trial of the impact of a home visitation
program for preventing child maltreatment, Eckenrode et al. (2000) found that, although most
families assigned to home visiting benefited with lower rates of subsequent child maltreatment,
treatment impact was nullified when mothers experienced ongoing domestic violence. This
moderation effect was robust; it was not impacted by violence severity nor mediated by mothers’
involvement in intervention. Other studies have similarly found that, in the presence of fathers’
violence (particularly domestic violence), children are more likely to require out-of-home
placement and be re-referred to child protective services regardless of child protective
intervention (English et al., 1999; English, Wingard, Marshall, Orme & Orme, 2000).
C. Potential Benefits of Intervening with Fathers
Caring Dads Theory May 2010
4
Caring Dads Theory Manual May 2010
Despite the prevalence and impact of fathers as perpetrators of child maltreatment,
efforts to understand and intervene to end child maltreatment have focused overwhelmingly on
children’s mothers, as documented in recent studies and reports written in the UK, Canada and
the US (Brown et al., 2008; McKinnon, Davies & Rains, 2001; Mayer et al., 2003; Risley-Curtiss
& Heffernan, 2003; Scourfield, 2003; Strega et al., 2008; Walmsley, 2009). Briefly, these
studies find that mothers are held primarily responsible for child safety, and that fathers are
mostly viewed as unimportant and irrelevant to child protection (McKinnon, Davies & Rain,
2001; Scourfield, 2003). For example, in a recent analysis of child protection practice, Strega et
al. (2008) found that social workers considered fathers irrelevant to both mothers and children
50% of the time. The tendency to view fathers as irrelevant to child protection practice even
extends to more severe cases. Cavanagh, Dobash and Dobash (2007) examined 26 fatal child
abuse cases in which a child had been killed by a father and found that even when fathers had
perpetrated serious assaults, they received minimal attention. All of these reports conclude with
the importance of shifting culture within child protective services, and interventions more
generally, to include fathers in assessing risk and in planning for child safety and well-being.
Following from this work, we see a number of important advantages to changing practice
to better include fathers in efforts to enhance the safety and well-being of their children. Some of
these reasons are listed below.
•
•
•
Benefits of a strong and healthy father-child relationship. One reason to focus on
fathers is the potential benefit of a healthy father-child relationship. Summarizing findings
from 150 studies, Allen and Daly (2007) concluded that positive father involvement is
associated with enhanced cognitive, social and emotional development among children.
Among families at-risk for child maltreatment, father presence has been associated with
lower levels of childhood aggression and depression, enhanced cognitive development
and greater child perceived competence (Marshall, English & Stewart, 2001). In
adolescence, having a positive relationship with a father protects against delinquency,
early sexuality, drug and alcohol use, and other risk behaviours. Thus, if fathers can
improve their relationships with their children, their children stand to benefit socially,
cognitively, and emotionally.
Additional route to ending violence against women. An appropriately targeted
fathering intervention program will enhance intervention to end violence against women.
There is an overlap of approximately 30% to 60% in men’s physical abuse of children
and abuse of children’s mothers (Edleson, 1999). In addition to directly exposing
children to violence against their mothers, domestically violent fathers use a variety of
tactics that are abusive towards their spouses and emotionally harmful to their children.
For example, abusive men may require children to monitor and report on their mother’s
behaviour, attempt to deliberately undermine the authority of children’s mothers or may
manipulate the child into seeing them as the best parent. Responsible fathering
intervention programs appreciate connections between fathers’ relationships with their
children and men’s behaviour towards their children’s mothers, and recognize the need
to directly address both. Thus, collaborative relationships between child protective
services, women’s advocacy and batterer intervention programs should thrive as a result
of intervention that addresses the fathering of domestically violent men.
Support to children’s mothers. A related benefit concerns fair practice within child
protection services. Current practice within child safeguarding services hold mothers as
primarily responsible for children’s well-being (e.g., Strega et al., 2008). This
responsibility extends to fathers’ relationships and behaviours with children. In fact,
under current child protection practice, mothers who are victims of domestic violence are
often directed to protect their children from their fathers (who they cannot protect
themselves from) under the threat of having their children removed. Similar failure-to-
Caring Dads Theory May 2010
5
Caring Dads Theory Manual May 2010
•
•
•
•
•
protect conditions are not used against fathers (Strega 2008). There are obvious
problems with a model of service that holds mothers responsible for controlling the
actions of children’s fathers. Models of intervention that access fathers directly to
address their risk are more appropriate, respectful and helpful to victimized mothers.
Emotional attachment between children and fathers. Children who have been
abused by their fathers, or who have been exposed to their fathers’ abusing their
mothers, have a wide range of reactions. Some children are anxious to end contact with
children’s mothers and fear that any continued contact will be unsafe for them and for
their mothers (Cunningham & Baker, 2004; Mullender et al., 2002). Others want to
continue to have a relationship with their father. In many cases, children describe
longing for a safe and healthy father-child relationship. Children who have been
maltreated have similarly varying perspectives, and often similar longings for a safe and
close relationship with their fathers. In our work with men in Caring Dads, we have been
struck by the intensity of men’s descriptions of losing relationships with their fathers
(mostly because he walked out of the family) and of their multiple efforts to try to reestablished a connection as children, teens, and as adults. A program such as Caring
Dads offers the opportunity to emphasize to fathers their importance in their children’s
lives, and to directly encourage them to commit to their children by ensuring they have
safe and healthy contact.
Potential to mitigate risks posed by maternal addiction and poor mental health.
Fathers also have the potential to “step-up” to the role of primary or sole caregiver when
children’s mothers are unwilling or unable to care for their children. Although care must
be taken to disentangle the effects of domestic violence on women’s capacity to care for
her children from the influence of other mental health and substance use problems,
there are families where fathers are more capable than mothers of parenting. In our
experience, these are most often cases where both parents have a history of addiction
but where the father has managed to get clean but the mother has not. There are a
number of published case studies now that highlight examples of fathers in the child
protection service who have taken on primary child care responsibilities when mothers
have been unable or unwilling to do so (Strega et al., 2009).
Modeling accountability, contributing to child healing. Providing intervention to
fathers also has the potential to increase paternal accountability and responsibility for
past abusive and neglectful behaviour. Rather than simply removing fathers, intervention
provides an opportunity for men to be accountable for their violence and to model taking
responsibility for their children (Peled, 2000). To the extent that men are able to accept
responsibility, they may play a powerful role in breaking the intergenerational
transmission of violence.
Fathers who leave one family seldom end their involvement with children in
general. Abusive fathers may be prevented from interacting with a particular set of
children, but these men typically become involved with other romantic partners and other
children. The threat that these men may pose to children of subsequent partners is
heightened because risk for violence perpetration is higher for stepfathers and other
non-biologically related male caretakers than for biological fathers (Daly & Wilson, 2000;
Radhakrishna et al., 2001). Thus, intervention while fathers are involved with one family
might prevent men’s abuse in a subsequent family.
Potential to monitor and contain fathers during follow-up from the child protection
and justice systems. Fathering intervention programs can also make observations
about men’s behaviour in group that might contribute to judgments about their parenting
and about the risk they may pose to his children and his children’s mothers. Following
child protection or family court involvement for domestic violence or child maltreatment,
Caring Dads Theory May 2010
6
Caring Dads Theory Manual May 2010
•
fathers may be in the position of having to demonstrate improved parenting prior to
gaining unsupervised or additional access to their children. In many communities, there
are few assessment or intervention resources available to help fathers reach this goal.
As a result, “time without incident” is often inappropriately used as an indication of
improvement. When fathers are deemed to be a risk to their children, fathering
interventions allow for a period of monitoring, where fathers’ relationships with their
families are being consistently reviewed and documented and where indicators of
progress, or lack of progress, can be provided to fathers and to other professionals
involved with the family.
Opportunity to support fathers in deciding to, or in being ordered to, limit their
contact with their children. Although it would be ideal for all children to have positive
and nurturing fathers, there are unfortunately cases where father-child contact may be
detrimental. Making judgements about whether fathers should or should not have
continued contact is not within the purview of the Caring Dads program. However, when
there are converging concerns about fathers, an intervention program can contribute to
helping fathers understand and cooperate with limits placed on their contact with their
children.
D. Summary
In summary, our child safeguarding and child and family mental health systems often
pay attention to fathers who have maltreated their children or exposed them to abuse of their
mothers. There are numerous compelling reasons to shift practice. As should already be clear,
however, our view of change does not rest solely with fathers, and the change we envision is
not merely the addition of another intervention program. Rather, we envision a shift in practice
towards meaningful consideration of fathers in ensuring that children, and often their mothers,
are safe from men’s abuse. As a part of that effort, an intervention program like the Caring Dads
group to attempt to help men cease their abusive behaviour is a useful addition. However, even
as we work to help individual men change, Caring Dads needs to contribute to cross-agency
efforts to ensure that victims of abuse are safe. Men’s change is only one route to success.
Containment and supervision of the highest risk fathers, extended supervision and protection
orders, and frank discussions with men about their need to take action to ensure that they are
safe for their family members are also necessary. These latter aims require case management
and the creation of working relationships between child protection, justice, batterer intervention
and child and family social services. Caring Dads is also about being a catalyst for this change.
In the next section, we consider both the general and specific system requirements the set a
necessary context for Caring Dads.
SECTION 2: WHAT DO WE KNOW ABOUT THE SYSTEMS NECESSARY TO HELP KEEP
CHILDREN SAFE FROM MALTREATMENT FROM THEIR FATHERS?
Caring Dads is premised on the view that safeguarding children goes well beyond offering an
intervention program to fathers. If child safety is our primary goal, then it is necessary to expand
conceptualization beyond the individual change required of fathers in treatment and to consider
how children are protected (or not protected) from potential repeat maltreatment by their fathers
by the larger intervention system. This perspective on collaboration is entirely consistent with
the principles of the Working Together to Safeguard Children policies and guidance.
Specifically, we share the view that for those children who are suffering, or likely to suffer,
significant harm, joint working is essential to safeguard and promote their welfare and, where
necessary, to help bring to justice the perpetrators of crimes against children. In the following
section, we identify six specific areas of working together that are particularly important for
keeping children safe from abusive fathers: attendance, compliance, coordinated case
Caring Dads Theory May 2010
7
Caring Dads Theory Manual May 2010
management and containment, keeping the child in focus, and collaboration with domestic
violence services.
A. Involvement and engagement in intervention
In order for treatment to have any potential to reduce men’s risk of re-assault, fathers
need to attend the program. Unfortunately, engaging and retaining men in parenting services
has historically been extremely difficult (Raikes & Belllotti, 2006; Rimm-Kaufman & Zhang,
2005), and men report little interest in parenting interventions (Lengua et al., 1992). Engaging
fathers from high risk families is especially difficult. It is therefore unsurprising that engaging
fathers who have been abusive in their families is an especially daunting task. The population of
abusive, neglectful and violent fathers targeted as clients for Caring Dads often do not identify
problems with their parenting; instead they feel that they have been unfairly labelled and
targeted by the system. For example, one former client of Caring Dads program explained that
problems in his family resulted from his children’s mother: “His mother’s ruining it for us. She’s
enviousOhas him saying I’m an alcoholic, and now he won’t come to work with me anymore”.
Another attributed blame to his child: “(my son) knows just what to say to get under people’s
skin” while another discounted his child’s possible distress as manipulation: “They said he has
an emotional problem but he doesn’t. He’s just lazy. He knows how to beat the system.” Other
fathers feel that their parenting is not abusive simply because it is significantly less abusive than
what they experienced in their families of origin.
Engaging these unmotivated, at-risk fathers requires joint efforts of all professionals
working within men’s families. Case workers within social care need to begin to include fathers
in their case conceptualization and planning and to engage fathers in child protection plans.
Within the justice system, greater attention needs to be given to the fact that most men arrested
for assaulting their intimate partners are also fathers, and have children who have been
impacted by violence. Other sector professionals, as well, need to consider fathers as potential
targets for change. There are further challenges to ensuring that men who are referred to the
program arrive for an intake. Reminiscent of early batterer intervention programs, there is
sometimes a fairly steep decline in numbers from referral to intake (e.g., Cadsky et al., 1996).
Joint efforts are again required to ensure that fathers do not “fall through the cracks” and are
successfully engaged in change efforts.
Guidance is available for working together to engage fathers. There are a variety of
reports available with recommendations for improving fathers’ engagement in services and
examples of successful outreach efforts (e.g., Australian Government Department
of Families, Housing, Community Services and Indigenous Affairs, 2009, Raikes & Belllotti,
2006). There is also evidence that when at-risk fathers can be engaged in family-improvement
efforts, the efficacy of all forms of intervention improve (Bagner & Eyerg, 2003; Palm & Fagan,
2008), again confirming that these joint efforts are worthwhile.
B. Compliance with intervention
A second area in which systems must work together to ensure child safety is in response
to fathers who fail to comply with intervention. There is now a convincing body of literature from
studies of batterer intervention that men’s compliance with attendance requirements is an
important predictor of re-assault. Estimates across studies suggest that there is about a 20%
change in risk for re-assault associated with dropout from batterer programs. In other words,
men who fail to complete are about 20% more likely to re-assault their partners (Bennett,
Stoops, Call & Flett, 2007; Gondolf, 2001). Moreover, failure to comply with intervention is one
of the best predictors of future assault currently available. Studies of repeat incidents of child
maltreatment have also identified parent cooperation as an important predictor of recidivism
(Baird, 1988; English & Marshall & Orme, 1999). Coohey and Zhang (2006), for example,
Caring Dads Theory May 2010
8
Caring Dads Theory Manual May 2010
reviewed files of 228 families involved with child protective services for supervisory neglect of
their children. She found a positive relationship between fathers’ taking responsibility for abuse
and lower risk for recurrence. In combination from more general results from literature on child
protection and batterer intervention suggests, these results confirm that systems designed to
keep children safe from men’s abuse will need to be able to monitor men’s compliance with
intervention and be responsive to men’s failures to comply.
C. Coordinated Case Management in Response to Unchanging or Rising Risk
Currently, one of the most common recommendations for increasing the safety of child
and women victims of violence is increased communication and coordination across agencies
(Allen, 2006; Douglas & Cunningham, 2008; Pennington-Zoellner, 2009). Such communication
has been found to be critical for monitoring, sharing and responding to increasing levels of risk
to potential victims of abuse. The Working Together legislation aligns with recommendations for
coordinated case management and further, provides a framework for joint work in strategy
discussions and child protection conferences. Unfortunately, despite intervention, some fathers
will pose unchanged risk to their children. For others, risk might increase during the course of
intervention due to individual circumstances (e.g. becoming depressed) or family circumstances
(e.g. separation, birth of a new child). To protect the potential victims of these fathers, it might
be necessary to work together to contain the opportunity of perpetrators to offend by legally
removing parenting rights and placing children with new caregivers, issuing restraining orders to
prevent contact, or requiring that perpetrators serve a period of imprisonment.
There is preliminary, but growing, empirical evidence from across fields that coordinated
practice to contain risk is a successful intervention strategy. Bringing a child into care is
considered an intervention of last resort within child protection, and only a small percentage of
children investigated by child welfare are removed from their home. These children have almost
always been victims of repeated and chronic maltreatment. There is evidence that, among these
severely maltreated children, containment of parents’ capacity to maltreat is often associated
with the best long-term outcomes. Forrester and Harwin (2008), for example, compared the
outcomes of a large sample of children coming into care due to concerns about their parent(s)’
use of substances. At a two-year follow-up point, children who remained at home had suffered
significant harm more often and were more likely to show continued problems than children who
were removed from their parents’ care. Similar conclusions were reached by Sinclair et al.
(2005) and Harwin et al. (2003) both of whom found that children who were taken into care
tended to make good progress physically and psychologically, unless they were returned home.
In the study of batterer intervention, similar conclusions are being reached about the
importance of containing the highest risk offenders. In this field, it has been found that there is a
small proportion of offenders (between 15 and 20%) who perpetrate violence frequency and
who are most likely to cause the most severe injuries to their partners (Klein & Tobin, 2008;
Gondolf, 2001). Recognition of this small subgroup of batterers has prompted efforts to better
identify these highest risk offenders so that they can be incapacitated. There is also some
indirect evidence that, when offenders are incapacitated with swift and sure penalties for failing
to comply with court orders, rates of violence recidivism go down (Gondolf, 2001).
D. Keeping the child in focus
Keeping the child in focus is a fourth specific need for inter-agency practice when
working with maltreating fathers. Understanding and considering the child’s perspective is a
core commitment of the Working Together legislation. Specifically, local authorities need to
ascertain the child’s wishes and feelings and give due regard to their age and understanding
when determining what (if any) services to provide. The need to consider children’s perspective
is also necessary with intervening with fathers. Interventions for offenders typically have, as one
focus, offender accountability and restitution for their behaviour. Although an important aspect of
Caring Dads Theory May 2010
9
Caring Dads Theory Manual May 2010
offender treatment, such treatment seems to invariably lead to consideration of reconciliation
with the victim, and to the potential for service to drift towards meeting fathers’ needs, rather
than children’s. This tendency to focus on the perspectives of adults is made even more
complicated by the fact that men’s children are sometimes court-ordered to have some level of
voluntary or involuntary contact with their fathers and all too often are the lynch pin of the
family’s living situation. A recent referral to Caring Dads provides an example. The precipitating
incident was the father’s physical assault of his teenaged step-son. Following this incident, the
teen moved in with a relative because he did not want further contact with his stepfather.
Unsurprisingly, a goal of the stepfather in attending Caring Dads was to get his stepson to move
back into the home. A significant case management issue then became the amount of pressure
that could potentially be placed on the teen to forgive his father so that family living
arrangements could be restored. Professionals working with fathers and with other family
members must work together to anticipate such situations and ensure that the wishes and
needs of children, and not adults, remain the focus.
The commitment to maintain focus on children and children needs is supported, in part,
based on empirical data on the treatment of trauma. A primary need of children who have been
maltreated is a sense of physical and emotional safety in their current surroundings and
relationships (Bancroft & Silverman, 2002). This is an element of all trauma treatments, and it is
thought to be necessary for providing a framework in which children can heal (Herman, 1992;
van der Kolk & McFarlane, 1996). Practically, this means, first and foremost, that abusive
fathers need to stop abusing their children. It is only when fathers are able to provide a
consistently nonabusive environment that children’s sense of emotional security can be rebuilt.
A second critical element is empowering the victim to make choices about forgiveness and
reconciliation (Freedman, 1998). Children need to be given some choices about contact with a
parent who has abused them and about whether and when past abuse may be discussed.
Thus, the final component of ensuring child safety is to work with fathers, referral agents and
sometimes other professionals in the system to ensure that children are empowered to
contribute to decisions about level of contact with their fathers and have their fathers disengage
from their often intense efforts to reunite the family as fast as possible.
E. Appreciating the overlap between child maltreatment and domestic violence
A final requirement for effective interventions with fathers who have maltreated their
children is strong collaboration and partnership with professionals working to end domestic
violence. Children’s exposure to domestic violence is, independent of other maltreatment,
harmful to child development and is classified as a reason for child protection in some
jurisdictions (Minnesota in the US, Ontario in Canada). Three past meta-analytic studies on the
impact of child exposure to domestic violence have confirmed that domestic violence impacts
children’s emotional and behavioural problems (Evans, Davies & DiLillo, 2008; Kitzmann,
Gavlord, Holt & Kenny, 2003; Wolfe, Crooks, Lee, McIntyre & Jaffe, 2003). Moreover, the
effects of abuse become more profound with each additional form of violence experienced by
the children (Felitti et al., 1998).
Men’s perpetration of domestic violence is also a consistent correlate of father-child
maltreatment. In both clinical and non-clinical populations, men’s abuse of their intimate
partners has been shown to overlap significantly with their perpetration of child physical abuse,
with a co-occurrence in the range of 30% to 60% (Edleson, 1999). In our past studies of clients
referred to Caring Dads, we have documented even higher rates of overlap. In semi-structured
interviews of 45 men referred to Caring Dads over a one-year period we found that, although
men were primarily referred for physical or emotional abuse, the ability of men to maintain a
respectful and non-abusive relationship with their children’s mothers was a key problem in 80%
of cases (Scott & Crooks, 2007).
Caring Dads Theory May 2010
10
Caring Dads Theory Manual May 2010
Children who are both direct victims of abuse or neglect and witnesses of domestic
violence are especially vulnerable to poor outcomes, and are recognized by the Working
Together initiative as a group with complex needs requiring even greater joint intervention.
Studies have shown that domestic violence is related to the severity of abuse children are likely
to experience and the intrusiveness of intervention necessary for protection (Dixon et al., 2007;
Coohey & Zhang, 2006). Domestic violence has been implicated as a risk factor for fatal fatherperpetrated child maltreatment (Cavanagh et al., 2007; Yampolskaya & Greenbaum, 2009). Due
to the overlapping nature of child maltreatment and domestic violence, partnerships are required
with domestic violence intervention services for both men and women. For men, such
partnerships address questions such as: When a father has perpetrated both child abuse and
domestic violence, which treatment program should he be referred to first? How should referrals
flow between the domestic violence and Caring Dads programs? Other dilemmas arise from the
changing situation in the home. A fairly common situation is that of a formerly abusive,
domestically violent and authoritative father who begins to move away from a harsh position
with the children. In such cases, the children frequently begin to act out and the mother, whose
authority has been eroded over time, is unable to enforce household routines and structures.
Collaborative case work is necessary in such cases to ensure that mothers in this situation are
given time for their own change and are not judged as incompetent parents relative to fathers,
who are now sometimes (and often inappropriately) viewed as stellar examples of treatment
success.
F. Summary
It is clear that protection of the safety and well-being of children requires working
together. Within the broader context of joint practice, there are specific areas of intervention with
abusive fathers, identifiable in review of the literature, that are likely to place a high demand on
collaborative practice. In the organization of intervention for maltreating fathers, it is critical to
have partnerships with child services and intervention services for abused mothers. Once
potential clients are identified, collaborative practice will likely be necessary for successful
referral and for ensuring men’s compliance with intervention. Coordinated case management
will also be necessary to contain fathers who fail to make progress during intervention and/or
who continue to present a risk to their children.
SECTION 3: WHAT DO WE KNOW ABOUT PROMISING INDIVIDUAL TREATMENT
OUTCOMES NECESSARY TO HELP KEEP CHILDREN SAFE FROM ABUSE FROM THEIR
FATHERS?
In this section, we review the empirical evidence on treatment targets relevant to men’s
abuse of children and children’s mothers. Over the past three decades, there has been
incredible growth in research on the predictors of mother’s abuse and neglect of children, and
on the effect of children’s exposure to their fathers’ abuse of their mothers. However, there is
relatively little research available on the characteristics and treatment needs of fathers who
have physically or emotionally abused or neglected their children, and limited research on
fathering among populations of men who batter their intimate partners. Necessarily then, the
current review of literature draws heavily on studies of related populations – specifically,
empirically supported treatment needs of mothers who have maltreated their children and
criminogenic needs of men who have abused their intimate partners. Fortunately, there is some
significant overlap in core risk factors emerging from these literatures. In the following section,
we present evidence for seven treatment targets that we consider most promising for
intervention with a population of maltreating fathers.
A. Anger/hostility/over-reactivity
Caring Dads Theory May 2010
11
Caring Dads Theory Manual May 2010
The role of anger in child maltreatment has been consistently supported in meta-analytic
studies and reviews of the predictors of child maltreatment (Black, Slep & Heyman, 2001; Black,
Heyman & Slep, 2001; Stith et al., 2009). In a meta-analytic review of over 150 studies of risk
factors for maltreatment, Stith et al. (2009) found that anger/hostility was among the three
strongest predictors of child maltreatment currently available. Researchers believe that high
levels of anger and negative arousal, when combined with negative beliefs and interpretations,
interfere with rational problem solving and information processing (Slep & O’Leary, 2001) and
lead to aggressive cognitions and impulses (Mammen et al., 2002).
Elevations in generalized anger and hostility are also implicated as a risk factor in men’s
perpetration of domestic violence (Schumacher, Feldbau-Kohn, Slep & Heyman, 2001). On the
basis of meta-analytic findings that elevated levels of anger and hostility consistently
distinguished intimately violent men from non-intimately violent men in both relationshipdiscordant and non-discordant partnerships, Norlander and Eckhardt (2005) suggested that
elevated anger and hostility are distinguishing characteristics of batters. Recently published
studies continue to find that anger is a strong and direct predictor of men’s violence towards his
intimate partner (O’Leary et al., 2007), that it interacts with alcohol use to predict violence over
time (Schumacher et al., 2008) and is associated with higher program attrition, re-arrest and
violence rates following treatment (Eckhardt, Samper & Murphy, 2008; Murphy, Taft, Eckhardt,
2007).
Anger and hostility have been examined in a few studies of risk factors for fathers’ abuse
of children. Francis and Wolfe (2007) compared 24 abusive and 25 nonabusive fathers and
found that abusive fathers reported experiencing higher levels of anger and hostility and were
more likely than the non-abusive fathers to express their anger through verbally or physically
aggressive behaviour. Group differences were robust; approximately half of abusive fathers
reported clinically significant levels of trait anger and outward expression of anger as compared
to less than a quarter of non-abusive comparison fathers. Other studies indirectly support
elevated anger among abusive fathers. For example, in Cavanagh, Dobash & Dobash (2007)’s
review of 26 cases of fatal child abuse perpetrated by fathers, they found that “low tolerance” for
child behaviour was often an antecedent of the fatal assault.
B. Family cohesion / coparenting / domestic violence
A second consistent risk factor for child maltreatment is the presence of high levels of
family conflict. In Stith’s (2009) meta-analysis of the predictors of (primarily mothers’)
maltreatment of their children, each of the constructs high family conflict, low family cohesion
and domestic violence were among the strongest predictors of child physical abuse. These
variables have also been studied with fathers. In an early, carefully controlled case-control
study, Perry, Wells and Doran (1983) found that a key difference between abusive and nonabusive fathers was their perception of family cohesion. Abusive fathers reported lower family
cohesion and greater levels of conflict. Following up on this work, Schaeffer et al (2005) found
that low family cohesion, expressiveness and high levels of family conflict predicted men’s child
abuse potential in a sample of military fathers. Pittman & Buckley (2006) similarly found that,
compared to abusive mothers, abusive fathers perceived less family cohesion, less
expressiveness in the family and less family organization, suggesting that family climate may
play an even more important role as a risk factor for fathers than for mothers.
Within the literature on family cohesion, co-parenting has been identified as the specific
aspect of family functioning that is most important to understanding risk to children. Numerous
studies have found that coparenting mediates the relationship between martial quality and
parenting practices (Davies, Struge-Apple & Cummings, 2004; Morrill, Hines, Mahmood &
Cardova, 2010), such that coparenting alliance and not marital quality is most strongly related to
poor parenting. Quality of coparenting is also an important predictor of child outcomes
(Feinberg, Kan, and Hetherington, 2007). For example, using a community sample of fathers
Caring Dads Theory May 2010
12
Caring Dads Theory Manual May 2010
characterized by marital violence, Katz and Low (2007) found that co-parenting contributed to
the prediction of children’s adjustment even when marital violence was controlled for. Together,
these studies suggest that reducing hostility on co-parental relationship is an important target of
treatment of fathers.
A second necessary treatment target is men’s perpetration of violence against children’s
mothers. Exposure to domestic violence, in and of itself, is a significant risk to child emotional
and behavioural health and well-being (Evans et al., 2008; Kitzmann et al., 2003; Wolfe et al.,
2003). Moreover, as already reviewed, there is a high rate of overlap in men’s perpetration of
maltreatment against children and children’s mothers (Edleson, 1999). Finally, cases of child
maltreatment with co-occurring domestic violence tend to result in more serious and longer term
harm to children (Cavanagh et al., 2007; English, Edleson & Herrick, 2005).
C. Perceptions of the child as a problem
A third factor for which there is converging evidence of risk is negative beliefs and
attributions. In review of the literature, both Stith (2009) and Black et al. (2001) concluded that
mothers who view their children as problematic and as intentionally engaging in negative
behaviours are at considerably greater risk for maltreatment. Perhaps the most intriguing
research in this area has been done by Bugental and her colleagues. Using a combination of
parent-child interaction and computer simulation standardize child responses, they found that
mothers who attribute greater power/blame to their children for the outcome of interactions are
more reactive to perceived child misbehaviour, use more punitive force and are more likely to be
abusive (Bugental et al., 1989; 1996, 1999a, 1999b, 2002).
Similar findings are present in the literature on predictors of battering (Wallach & Sela,
2008). In a review of the literature on predictors of male-to-female intimate partner violence,
Schumacher et al. (2001) identified negative attributions as an important contributor to violence.
In support of this contention, studies have fairly consistently found that abusive men attribute
more negative intentions, selfish motivations and blame to their partners than non-abusive men
(Holtzworth-Munroe & Hutchinson, 1993; Jin, Eagle & Keat, 2008; Tonizzo, Howells, Day,
Reidpat & Froyland, 2000). For example, Eckhardt and colleagues (1998) have shown that, in
response to anger-arousing scenarios, violent men articulate more belligerence and greater
hostile attribution biases than non-violent men.
There are a handful of studies that provide indirect support for the importance of
perceptions of the child as a risk factor for father-child maltreatment. In the three studies that
have examined parenting stress as a potential risk factor for men’s abuse (Francis & Wolfe,
2008; Lee et al., 2008; Schaeffer et al., 2005), all have found positive associations between
men’s abuse and their self-reported stress on the Parenting Stress Index (PSI). Perceived
difficulty of the child is an important component of this scale, and as discussed by Francis and
Wolfe (2008), it is possible that fathers’ elevated scores on these items represent distortions in
expectations of children. On a similar vein, Perry and her colleagues (1983) found that
expectations of abusive fathers for their children’s development were more discrepant from
norms than those of control fathers, and suggested that these distorted expectations may have
contributed to men’s perceptions of their children as problematic. Finally, Cavanagh, Dobash &
Dobash (2007) found that low tolerance for normal child behaviour was often an antecedent of
fatal father-child assault.
D. Use of corporal punishment and other aversive behaviours
Theoretical models of the development of child abuse suggest a cyclical process by
which negative child behaviour is followed by harsh and ineffective parenting repeatedly over
time with both child behaviour problems and harshness of parents’ responses continually
increasing (Wolfe, 1999). Consistent with these development models, studies have found that
lower-level negative parenting behaviours predict abuse. Specific attention has been paid to two
Caring Dads Theory May 2010
13
Caring Dads Theory Manual May 2010
main behaviours. The first is parents’ use of corporal punishment. Among mothers, use of
corporal punishment is a strong predictor of physical abuse (see meta-analysis by Stith et al.,
2009). The second is negativity in observations of parent-child interactions. Literature in this
area was recently reviewed by Wilson, Rack, Shi and Norris (2008) who concluded that abusive
parents engaged in significantly more aversive behaviours towards their children than nonabusive parents and that the effect size difference between the groups was medium in size.
Once again, these findings are echoed in the literature on battering which shows that
physical abuse is strongly predicted by lower severity aversive behaviours such as emotional
and verbal abuse. For example, in review of the literature on predictors of men’s IPV,
Schumacher et al. (2001) concluded that psychological aggression is a consistent risk factor for
men’s violence with effects ranging from medium to large. Recent modelling studies have also
continued to find strong and direct associations between men’s verbal abuse and violence
perpetration (O’Leary et al., 2007).
Few studies have examined the relationship between men’s aversiveness to their
children and father-perpetrated abuse, and those that have been published have inconsistent
results. Silber et al. (1993) compared abuse and non-abusive fathers in interaction and found
that abusive fathers directed more averse behaviours, control and criticism toward their children
than did non-abusive fathers. Whipple and Webster-Stratton (1991) failed to find differences,
though similar observational protocols were used. There are no recent observational studies of
fathers who have maltreated their children or used violence against their children’s mothers.
E. Quality of parent-child relationships
Parallel to the research on aversiveness, having a positive and involved parent-child
relationship has been shown to protect against maltreatment in the mother-child relationship.
The quality of the parent-child relationship has most often been assessed by observation,
interview or q-sort methodology. Across methods, a significant negative association between
the quality of parent-child relationship and maltreatment has been found (Stith et al., 2009;
Wilson et al., 2001). Wilson’s meta-analysis of observational studies comparing abusive and
non-abusive parents (the vast majority of whom were mothers) sheds more light on the specific
nature of positive parent-child relationships. He examined the specific constructs of positivity
and involvement. Both were protective against maltreatment with effect sizes in the medium to
large range (.53 minimum to .62 maximum) such that non-maltreating parents on average are
between one-half and two-thirds of a standard deviation higher than maltreating parents in
terms of displaying involvement during parent–child interactions.
A handful of studies have examined positivity in the father-child relationship and its
protection against abuse. Lee, Guterman and Yookyong (2008) found that, among White
fathers, higher levels of father-child involvement predicted lower levels of spanking. Other
studies have found that abusive and non-abusive fathers can be distinguished on measures
relevant to their ability to emotionally attune to their children. Using a sample of mothers and
fathers, Perez-Albeniz and de Paul (2004) found that abuse potential was related to low levels
of parent empathy for their children. Francis and Wolfe (2008) reported that, compared to nonabusive fathers, abusive fathers were less likely to try to consider their child’s perspective, felt
less empathetic concern and were poorer at accurately recognizing children’s emotions. Finally,
English et al. (2005) found that in families where there was domestic violence, re-referral to
child protection for maltreatment was uniquely predicted by positive aspects of the father-child
relationship, specifically fathers’ nurturance, acceptance and protection.
F. Self-centeredness
Another construct that is likely important to understanding fathers’ risk of maltreating
their children is men’s self-centeredness. For all parents, one of the key tasks of parenting is
recognizing and prioritizing needs within the parent-child relationship. The process of identifying
Caring Dads Theory May 2010
14
Caring Dads Theory Manual May 2010
and weighing parent and child needs relative to each other closely resembles that of a
balancing act, whereby the needs of the child and the needs of the parent must be constantly
considered. When children are young, and highly dependent, parents must meet all of their
needs for physical and emotional resources. In order to meet these needs, the parent must
often put aside their own needs, for things such as sleep and private time, resulting in an
uneven balance that favours the child. Parenting young children therefore requires a relatively
unique element of altruism, necessary for the healthy development of children. For many new
parents, the level of unselfish concern required for the optimal care of their children represents a
level of selflessness not previously required of them. As such, altruistic parenting may represent
a developmental challenge for new parents, whereby adaptation to a new set of parameters and
roles is required for the development of healthy parent-child relationships. As the child grows,
the balance between parent and child needs begins to shift towards greater equilibrium and
parents are afforded more discretion in terms of how needs within the relationship are
prioritized, or weighed, relative to each other. Nonetheless, the resources and position of the
parent relative to his child continue to require parental balancing to ensure that the child’s needs
are being met, even as the child becomes physically self-sufficient.
Past descriptive work by Scott and Crooks (2004, 2007) and Bancroft and Silverman
(2002) has suggested that maltreating fathers may be particularly challenged to shift towards
adequate recognition and prioritization of children’s needs for love, respect, and autonomy and
that this inability to prioritize needs is primary to their maltreatment of children. Rather, abusive
fathers have an egoistic orientation to parenting (Wiehe, 2003), whereby parents see their
children as extensions of themselves, or of their own experiences and where parenting is
organized around the parent’s needs (Newberger & White, 1989). This suggestion is consistent
with parallel research in the domestic violence literature, where it has been found that men who
abuse their intimate partners are characterized by an over-sensitivity to rejection, a high need
for control, a narcissistic sense of self-importance, and feelings of entitlement (Dutton, 1996,
1998). Research has also suggested that abusive men tend to believe that they deserve
unconditional love and respect from their families and when such treatment is not forthcoming
they tend to feel victimized and justified in avenging these slights (Francis & Wolfe, 2008).
G. Misuse of Substances
A final risk factor for child maltreatment with strong empirical support is parental misuse
of substances. Mothers’ use of substances has been shown to co-vary with child maltreatment
in a number of studies and meta-analyses (Stith et al., 2009, Young, Boles & Otero, 2007),
though others have found that the predictive value of substance use is substantially reduced
when other risk factors are accounted for (e.g., Thompson & Wiley, 2009). There is no such
equivocation, however, in the literature on fathers. For men, the relationship between substance
use and violence, both against a partner and against children, appears to be very robust.
Alcohol problems are one of the most well-established risk factors for physical intimate
partner violence. In a 2008 meta-analytic review of this literature, Foran & O'Leary concluded
that there was a small to moderate effect of alcohol use on male-to-female violence and that this
effect was stronger for clinical populations. Other supportive evidence comes from a thoughtprovoking study on alcohol availability. McKinney, Caetano, Harris & Ebama (2009) linked data
from a national population-based survey of violence to alcohol outlet and census data and found
a direct association between the number of alcohol outlets and the frequency of intimate partner
violence. Specifically, they reported that an increase of 10 alcohol outlets per 10,000 persons
was associated with 34% increased risk of male-to-female partner violence and that this
relationship was even stronger among couple reporting alcohol-related problems. Although
there widespread agreement that alcohol use does not cause violence (not all alcoholics are
violent), studies have convincingly shown that use of alcohol significantly increases the
likelihood of violence especially among clinical populations. In one of the first studies in this
Caring Dads Theory May 2010
15
Caring Dads Theory Manual May 2010
area, Fals-Stewart, Golden and Schumacher (2003) carefully tracked both alcohol use and
violence over time. They found that the likelihood of male-to-female physical aggression was
significantly higher on days of substance use than on days with no substance use. More
recently, Mignone, Klostermann & Chen (2009) reported that in longitudinal follow-up of
batterers leaving an alcohol treatment program, men who relapsed to alcohol were much more
likely to relapse to physical aggression. Finally, Jones and Gondolf (2001) found that
drunkenness was the most influential risk marker for reassault among a large sample of
batterers followed over time.
Although there are fewer studies on men’s use of substances and their maltreatment of
children, studies that are available appear to echo the findings from the literature on battering.
Francis and Wolfe (2008) and Famularo, Stone, Barnum & Wharton (1986) both found that a
significantly higher percentage of abusive fathers (47.6%) than non-abusive fathers (8.3%)
reported problematic alcohol use. In Cavanagh, Dobash & Dobash (2007)’s review of fatal child
abuse cases, they found that 36% of fathers had problems with abuse of alcohol. There is also
evidence for an ongoing association of substance use and repeat maltreatment. In Coohey and
Zhang (2006)’s examination of cases of supervisory neglect, they found that cases of chronic
supervisory neglect were partially predicted by men’s having a substance abuse problem.
Summary
Review of the literature has identified seven promising treatment targets for reducing risk
for abuse among abusive fathers. Identified needs concern both men’s relationships with their
children and with their children’s mothers. Although each of these factors can be supported by
empirical research on mother-child maltreatment and from research on men who have abused
their intimate partners, there has been little research specifically examining fathers. Longitudinal
studies of change are still required to confirm and clarify mechanisms of change in fathers’
maltreatment of children. Nevertheless, each hold promise as targets for intervention for fathers
who have maltreated their children.
SECTION 4: DEVELOPING AN INTERVENTION PROGRAM FOR FATHERS WHO HAVE
BEEN ABUSIVE IN THEIR FAMILIES.
A. History
The Caring Dads program began in early 2000 as a result of shared concerns about
gaps in services to fathers. We began by bringing together a working group of individuals from
child protection, women's advocacy, probation and justice services, children's mental health
centres and family courts, batterer intervention and from two universities. Each member of our
group had immediate concerns about current practice. Women’s advocates expressed concerns
that, as in other communities, fathers who had been abusive towards their children or their
children’s mothers were increasingly being granted substantial co-parenting rights. No one was
intervening with fathers to end their ongoing psychological coercion of women following such
arrangements, or while custody and access decisions were being made. Both the batterer
intervention program and the child mental health service representatives noted that abusive
fathers were accessing their services more frequently and were concerned about a poor match
between the service provided and fathers’ needs. The batterer program addressed fathers’
relationships with children’s mothers and the effects of witnessing violence, but did not directly
address father’s parenting. The needs and perspectives of these abusive fathers tended to
overwhelm general parenting education programs and leaders were concerned that men’s core
risks for abuse were not being addressed. Probation services reported that men who had
assaulted their intimate partners were often being ordered to attend a parenting program, but
that none of the available programs addressed men’s abuse-related needs. Finally, those from
Caring Dads Theory May 2010
16
Caring Dads Theory Manual May 2010
child safeguarding services expressed motivation to involve fathers more closely in their case
formulation if there was a way to address risks that men posed to children.
To address these concerns, we deemed it necessary to create a new program. Thus
began the development of the Caring Dads: Helping Fathers Value their Children intervention
program. The lead developer of the program was Dr. Katreena Scott at OISE/University of
Toronto, who worked in close collaboration with three other co-developers: Dr. Claire Crooks,
Research Scientist at the Centre for Research on Violence Against Women and Children; Karen
Francis, who was at the University of Western Ontario; and Tim Kelly, Executive Director of
Changing Ways, London (Inc.). A working group from the Emerge batterer intervention agency
in Boston became an early partner and also contributed to programming. Over the next few
years, the Caring Dads program took shape. There was incredible community support. In
addition to being on the Advisory Committee, key community leaders co-facilitated groups, ran
intake interviews, provided feedback on final reports, and provided in-kind contributions of
space and resources. In fact, the estimated in-kind contribution of these agencies to Advisory
Committee activities over 1 year sums to 432 hours, or $22,968 of in kind contribution. The
collaborative nature of program development, the contribution of individuals with many years of
experience and considerable expertise, and the university-community partnership at the heart of
this program, instils some confidence that Caring Dads is based on our best thinking to date on
how to intervene with abusive fathers.
This section of the manual covers information relevant to intervention theory and goals
that direct Caring Dads’ work with fathers, mothers and with the broader system of intervention.
This part of the manual is divided into three sections. In the first section, we discuss the
intervention group program for fathers. We provide a brief description of the content and
activities of group and then review the intervention theory that guides work during that section.
In the second and third sections, we repeat this process for the mother contact and coordinated
case management components of the program.
B. Overview of the Caring Dads group intervention for fathers
The most salient component of the Caring Dads program is a group intervention for
fathers who have physically or emotionally abused or endangered their children, neglected their
children, have perpetrated abuse against children’s mothers or are deemed at high-risk for
engaging in these behaviours. Referrals for the program ideally come from social care as part of
a child safeguarding plan, though fathers may also be referred directly from police or courts,
from the IDAP program or through other services so long as there is some direct involvement of
the child with social services. Caring Dads groups are organized into 17 two-hour group
sessions. Groups are co-facilitated by a male and female co-facilitator with knowledge and
experience in intervention with men, child protection, child development, and woman's advocacy
(see program manual). Following recommendations for group therapy (Stewart, Usher &
Allenby, 2009), there are about 12 men enrolled in each group.
The basic modules of the Caring Dads group program are briefly described as follows
(they are outlined greater detail in the program manual):
• Module 1: To develop sufficient trust and motivation to engage men in the process
of examining their fathering. Most of the fathers referred to Caring Dads see few or no
problems with their parenting and have a tendency to blame the system, their children or
their children’s mothers for their referral. Thus, a first therapeutic goal is to develop trust
and engagement so that men can be challenged. Suggested exercises use motivational
interviewing strategies to develop men’s motivation. Men are encouraged to explore
difference, and the potential for difference, between their current fathering, the fathering
they experienced as children, and their goals and ideals for their relationships with their
children. Counsellors remain flexible to having men voice their concerns about attending
group and work towards building a sense of trust and group cohesion.
Caring Dads Theory May 2010
17
Caring Dads Theory Manual May 2010
•
•
•
Module 2: To increase men's awareness and application of child-centred fathering.
Focus is next placed on men's awareness of ‘child-centred’ fathering. Using a
combination of psychoeducational and behavioural interventions (e.g., modelling,
directed practice, assignment of homework), men are taught skills for listening, praising,
nurturing, considering child development, communicating with their children and for
supporting their children’s mothers. Men are continually encouraged to consider
parenting choices along a continuum of meeting parent needs or child needs and are
encouraged to rebalance their behaviours and priorities so that they are better able to
meet children’s needs (one of which is for a respectful and non-abusive treatment of
mothers).
Module 3: To Increase men's awareness of, and responsibility for, abusive and
neglectful fathering and their impact on children. One of the important guiding
philosophies to this section of the manual is that until men have stopped abuse and at
least begun developing a trusting and positive relationship between themselves and their
children and their children’s mothers, there is nothing they can do as fathers to progress
towards a healthier father-child relationship. With this in mind, a number of weeks are
focused on challenging men to become aware of, and take responsibility for, their
abusive and neglectful fathering behaviour and for the hostility that they express towards
children and children’s mothers. Cognitive behavioural therapeutic strategies are used to
help identify and interrupt abuse-supporting thoughts and behaviours. Clear behavioural
goals are set for each client and facilitators monitor men’s progress in being able to
apply concepts learned in group to behaviours with their children and families.
Module 4: Rebuilding trust with children and planning for the future. By the end of
the group, fathers sometimes feel that they have begun to interact differently with their
children, but that their children, or their mothers, are not reciprocating. They may also
feel that children’s mothers or other individuals in their children's lives are not adequately
rewarding the changes that they have made. Potential reasons that children may take
some time to trust changes in men’s fathering are discussed. The importance of
consistency in non-abusive behaviour and in greater cooperation with other individuals
and systems in their children's lives is emphasized. Honest and difficult conversations
about ‘the most the men can hope for’ are also part of this section of the group as is
planning for additional interventions or support that may be needed for men and their
families.
The following table summarizes each module in terms of the key intervention strategies (Crooks
et al., 2006) used in each module, the empirically-supported treatment needs and target
outcomes. Details are provided in the narrative provided for each module.
Table 1. Summary of Intervention Strategies, Treatment Needs and Target Outcomes for
each Caring Dads Module
Program
Component
Caring
Dads
Module 1
Intervention
strategies
Motivational
interviewing
Prosocial group
processes
Treatment needs
addressed
Engagement in
examining fathering
Compliance with
intervention program
Target Outcomes
By the end of this module, fathers
will:
- commit to attending and
complying with Caring Dads
intervention
- identify problems in their own
behaviour in at least one
relationship within the family
Caring Dads Theory May 2010
18
Caring Dads Theory Manual May 2010
Caring
Dads
Module 2
Psychoeducation
Caring
Dads
Module 3
Cognitive
behavioural
therapy
Behavioural skills
training
Perceptions of the
child as a problem
By the end of this module, fathers
will:
- actively care for their children for a
Family
reasonable amount of time
cohesion/coparenting
(“reasonable” will vary depending
on fathers’ living situation, but at
Self-centeredness
minimum, fathers who live with
their children will spend at least 30
Quality of parentminutes a day in direct interaction)
- interact with their children in a
child relationships
child-centred manner (i.e., focus
on child’s choice of activities or
discussion topics)
- praise and positively reinforce
their children
- generate multiple possible
explanations for child
misbehaviour
- anticipate and rehearse positive
and non-abusive methods for
dealing with child misbehaviour
- avoid physical punishment, namecalling, overly rigid rules, and
using other forms of harsh
parenting
- support children’s relationships to
their mothers (e.g., speak
positively to children about their
mother, model respectful
treatment)
Anger/hostility/overreactivity
Domestic violence
Use of corporal
punishment and
other aversive
behaviours
Self-centeredness
Caring
Dads
Trauma theory
Keeping the focus on
the child
By the end of this module, fathers
will:
- respond to problems in family
relationships in less anger,
irritability and unpredictability
- cooperate respectfully with
children’s mothers in making
decisions about parenting
- avoid degrading, manipulative,
undermining and otherwise hurtful
comments or behaviours to or
about children’s mothers
- avoid behaviours that are
emotionally or physically abusive,
neglectful or otherwise hurtful to
children
- maintain safe use of substances
(specifics will vary by client)
By the end of this module, fathers
will:
Caring Dads Theory May 2010
19
Caring Dads Theory Manual May 2010
Module 4
Collaborative case
management for
containment
- identify specific impacts of their
past abuse on children, children’s
mothers and on the mother-child
relationship
- hold realistic, child-centred
expectations for their continued
relationship
C. Module 1, Sessions 1-3: To develop sufficient trust and motivation to engage men in
the process of examining their fathering
The first module of the Caring Dads program consists of an intake interview and three
group sessions. The treatment outcomes expected for module 1 are for fathers to:
• commit to attending and complying with Caring Dads intervention
• identify problems in their own behaviour in at least one relationship within the
family
As outlined in the review of literature, men identified by child protection, justice, or child care
services as being abusive or neglectful are often quite resistant to any further involvement of
professionals. These men generally view the program as a service for others, see the group
goals as irrelevant to their situation, feel angry that others are asking them to change, and be
distrustful of program leaders who they anticipate will blame them for problems. In other words,
fathers who attend Caring Dads are generally precontemplative with respect to personal change
(Prochaska & Diclemente, 1982). The idea of being precontemplative to change derives from
the transtheoretical model of change (Prochaska, DiClemente & Norcross, 1992). Research on
this model confirms that individuals vary in their perspectives on change, and that change
attitudes predict outcome. Specifically, clients who do not see a need to change (labelled
precontemplative) are less likely to do so in traditional intervention programs (Murphy & Baxter,
1997; Scott & Wolfe, 2003). For these precontemplative clients, the first intervention goal must
be to develop motivation, or using the terms of the transtheoretical model, shift from the
precontemplation to contemplation stage of change (i.e., acknowledging the desire and need to
make some changes in behaviour) early in the intervention process.
Fortunately, there have been considerable advances in understanding of how to best
promote a shift between the precontemplation and contemplation stages of change. Motivation
interviewing (MI) (Miller & Rollnick, 2002) is a strategy of intervention designed to reduce
dropout and improve outcomes among clients who are reluctant to attend treatment and/or
change their behaviour. Therapists using MI focus on four primary intervention techniques: (a)
expressing empathy; (b) developing discrepancies between clients’ current behaviours and
desired outcomes; (c) rolling with resistance (or avoiding confrontation); and (d) supporting selfefficacy for change. For facilitators of Caring Dads, motivational interviewing requires the
development of a therapeutic stance that recognizes the duality of needing to both adopt a
nonconfrontational, motivation-enhancing stance, as well as hold men accountable for abusive
behaviour (Perel & Peled, 2008). At one level, professionals must recognize that an abusive
man is someone who poses a significant threat to the children (and possibly women) in his life.
From this perspective, themes of power and control need to be identified, monitored and
confronted. At the same time, therapists must empathize with the individual, who usually
understands his experience very differently. He may either see himself as a victim with minimal
control over his children (Bugental, Blue & Cruzcosa, 1989), or conversely, he may take great
pride in his parenting and view it as the one thing he does well (Perel & Peled, 2008).
Recognizing the tension between the realities of clients and professionals is paramount to
Caring Dads Theory May 2010
20
Caring Dads Theory Manual May 2010
successfully engaging maltreating fathers. It requires a compassionate stance that nonetheless
maintains clear guidelines about the unacceptability of violence as a strategy to control others.
Motivational interviewing is an empirically supported strategy of intervention. In
controlled studies, motivation enhancing interventions have been shown to have positive impact
on treatment for a range of presenting problems including alcohol and drug use (Davis, Baer,
Saxon & Kivlahan, 2003; Stephens et al., 2000; Stotts, Schmitz, Rhoades, & Grabowski, 2001),
medical adherence (Maneesakorn, Robson, Gournay & Gray, 2007), cigarette smoking (Colby
et al., 1998), use alcohol (Monti et al., 1999), driving under the influence (Stein, Colby, Barnett,
Monti, Golembeske, Lebeau, 2006) and pathological gambling (Wulfert, Blanchard, Freidenberg
& Martell, 2006). There are a handful of studies supporting the utility of engagement enhancing
interventions for abusive men (Kistenmacher, 2001; Stosny, 1994). For example, Tolman and
Bhosley (1990) found that a supportive pre-group intervention lead to lesser dropout in the first
4 sessions of intervention. More recently, Taft, Murphy, Elliott & Morrel (2001) used a quasiexperimental design to examine the effectiveness of supportive phone calls and handwritten
notes from therapists after missed sessions. They found that the cohort who received this
intervention attended more treatment sessions and had a significantly lower dropout rate.
Finally, Scott et al. (in press) randomly assigned 144 highly resistant men to a 6-week
motivation enhancing intervention pre-group plus treatment-as-usual or to treatment-as-usual.
She found that men attending motivational intervention showed much higher rates of program
completion.
Exercises in the first three sections of the Caring Dads program were specifically
designed to facilitate the use of motivational interviewing. Fathers are asked to share details of
their parenting situations (e.g., genogram exercise) and begin to reflect on the often difficult
situation that they are now in due to their past choices (e.g., having only supervised contact with
their children, trying to support children from two or three different mothers). Fathers also
explore their experiences and perceptions of their own fathers and begin to reflect on
intergenerational patterns of abuse (e.g. fathering circles). These exercises provide fertile
ground for facilitators to recognize and reflect on discrepancies between fathers’ ideal view of
how they should relate to their children and their current actions. Facilitators are active
participants in this process because fathers are often unaware of, and seemingly “blind” to,
intergenerational patterns of abuse. A common example is a father who speaks poignantly
about the loss he experienced as a child when his father left the family, but who at the same
time, is ready to walk away from his own children because “they just get too upset when
visitation time ends”. Without the careful reflection of this discrepancy by facilitators, this father
is unlikely to make the connection between his experience as a child and the likely experience
of his own children. Such connections, when made, provide a powerful incentive for men to
engage in the Caring Dads group to learn more about improving their relationship with their
children. A final exercise in this section of the program is a goal development exercise. After
considering discrepancies, fathers are asked to specify a goal for themselves to work towards
over the next 14 weeks of group.
Although MI is the main strategy of intervention used in early Caring Dads sessions, a
second strategy deliberately used by Caring Dads to engage fathers is the fostering of a healthy
prosocial group process. Group cohesion is developed by setting group rules, having each
father share details of their parenting situation and by facilitators’ attention to reflecting on
commonalities in men’s experiences and current situations. Developing group cohesion and
facilitating social support draws men into the group, and is also independently therapeutic.
Social isolation has been identified as a characteristic of abusive families in general (Cadzow,
Armstrong, & Fraser, 1999; Powell, 2003). For fathers, this lack of social support may be
exacerbated by rigid stereotypes and prescripted roles to which many of these men subscribe.
That is, while many of these fathers may lack social support in general, they are particularly
unlikely to have relationships with other men that allow them to discuss the challenges and joys
Caring Dads Theory May 2010
21
Caring Dads Theory Manual May 2010
of parenting in a healthy and productive manner. Universality (the perception of shared
experience) is recognized as one of the most powerful mechanisms of change in group therapy
(Yalom, 1970). A sense of being part of a group helps individuals feel that they are not alone,
provides hope for the future, and allows for the development of pride and self-efficacy through
sharing expertise and helping others solve problems in a healthy way. Of course, in Caring
Dads, facilitators need to take care that the focus of sharing is positive, and not rumination on
blaming others. In developing groups for parents of adolescents with conduct disorder, Moretti
and her colleagues (2004) found that a lack of structure in the group led to a process of “oneupmanship” whereby parents tried to outdo each other to determine who had the child with the
most outrageous behaviour. In our groups, we have seen a similar dynamic whereby men can
begin to coalesce around themes of child misbehaviour, inalienable paternal rights, and/or the
mental health of their partners. To prevent the focus of shared experience from being frustration
with intimate partners, or perceived persecution by the child protection system, careful
structuring and monitoring of group process is required. Nonetheless, creating a safe and
comfortable environment where men feel they can take risks and disclose difficult situations can
be a powerful experience for them; indeed, the client feedback from our groups tends to identify
this component (e.g., “being able to talk to other guys about this stuff”) as one of the most
beneficial aspects of the program from their perspective. This feedback is also consistent with
research showing that higher levels of group cohesion predict higher rates of program
completion and greater change among its members (Martin, Garske, & Davis, 2000; Horvath &
Symonds, 1991).
In summary, the Caring Dads program makes deliberate use of two strategies for
engaging men and developing their motivation to change. First, therapists use motivation
enhancing intervention to avoid confrontation and to instead help develop discrepancies
between men’s current actions and their desired relationships with their children and families.
Second, they actively work to develop prosocial group processes. Together, these strategies
provide the context and “buy in” for more challenging work later in the group and thus increase
the likelihood of success in intervening with men’s abusive behaviour.
D. Module 2, Sessions 4-9: To increase men's awareness and application of childcentered fathering.
The second module of Caring Dads focuses on developing fathers’ capacity to engage in
healthy, child-centred fathering; or stated in term of risk factors, to improve the quality of fatherchild relationships, decrease fathers’ perception of the child as the problem, increase respectful
co-parenting and reduce fathers’ self-centredness. The specific treatment outcomes expected
from this module are for fathers to:
• actively care for their children for a reasonable amount of time (“reasonable” will vary
depending on fathers’ living situation, but at minimum, fathers who live with their children
will spend at least 30 minutes a day in direct interaction)
• interact with their children in a child-centred manner (i.e., focus on child’s choice of
activities or discussion topics)
• praise and positively reinforce their children
• generate multiple possible explanations for child misbehaviour (e.g., to get attention, to
express anger, normal for their developmental stage)
• anticipate and rehearse positive and non-abusive methods for dealing with child
misbehaviour
• avoid physical punishment, name-calling, overly rigid rules, and using other forms of
harsh parenting
• support children’s relationships to their mothers (e.g., speak positively to children about
their mother, model respectful behaviour)
Caring Dads Theory May 2010
22
Caring Dads Theory Manual May 2010
In this module, there are multiple points of intersection with empirically validated parenting
intervention programs and with the literature on risk factors for fathers’ abuse. The above
treatment goals are mostly common to general parent training programs, and are addressed
with many of the same therapeutic strategies. The general strategy for presenting each new
parenting skill is as follows. First, psychoeducation is used. Concepts are clearly explained by
group leaders using a variety of presentation formats including lecture, group discussion, review
of worksheets, etc. Following education, positive skills or cognitions are modelled either by
facilitators, through video presentations or, in some cases, by fathers themselves. Fathers are
then encouraged to apply lessons to their understanding of their own children and are asked to
reflect on how application of skills might alter the father-child relationship. Finally, fathers are
assigned the task of practicing parenting in their weekly homework exercises.
There is considerable empirical support for parent training that includes psychoeducation
and skills practice (though primarily with mothers as fathers are seldom investigated). Literature
in this area was recently reviewed by Lundahl, Nimer and Parsons (2006), MacLeod and Nelson
(2000) and by Skowron and Reinemann (2005). These reviews concluded that parent training
resulted in a moderate positive effect on parents’ attitudes towards abuse and on incidence of
subsequent abuse. They further concluded that inclusion of a behavioural component (i.e.,
modelling, role play, practice) enhanced outcomes significantly. Other components related to
higher rates of success were home visitation and delivering some of the parent training in an
individual setting. Although further research is needed on parenting intervention with fathers
specifically, there is a solid empirical base to suggest that parenting psychoeducation and skills
practice is an effective intervention strategy.
Although there are many points of overlap in this module between Caring Dads and
empirically-supported parenting programs, there are four important differences. These include
the use of the parenting continuum, emphasis on modelling and teaching, focus on men’s
relationship with children’s mothers and continued deliberate attention to developing
discrepancies.
•
•
Use of the parent-centred to child-centred continuum. Caring Dads departs from
traditional parenting programs in its use of a parent-centred to child-centred continuum.
This continuum is used to teach men that choices that they make with regard to their
children can be understood as motivated sometimes by the desire to meet their
children’s needs (e.g., taking a child to a show he or she wants to see, reading to a
child) and sometimes by a desire to meet a parents’ needs (e.g., enrolling a reluctant
child in hockey because the parent wants the child to play). The inclusion and use of
continuum is based on the self-centeredness identified in research and clinical
descriptions of fathers who have maltreated their children or exposed them to abuse of
their mothers (e.g., Bancroft & Sliverman, 2002). The parent to child-centred continuum
is a powerful way to analyse fathers’ parenting decisions and it is often cited by clients
as one of the most helpful tools of the group. We also contend that it is a tool that is
specifically useful to abusive fathers due to their self-centredness in parenting choices,
and is not likely a good tool for parenting training more generally.
Emphasis on guiding, modelling and teaching. A second, more subtle difference
between Caring Dads and most parenting skills training is the emphasis placed on
guiding, modelling and teaching. Fathers, as compared to mothers, seem to identify
themselves as teachers and role models for their children, rather than as nurturers.
Thus, exercises in this section of the program motivate change by encouraging men to
consider what their children learn from watching them. Specific areas covered are what
children learn from watching men deal with frustration and anger and what children learn
from how men interact with children’s mothers and other important people in children’s
lives (e.g. grandparents, teachers, etc.).
Caring Dads Theory May 2010
23
Caring Dads Theory Manual May 2010
•
•
Continued attention to relationship with children’s mother. A third critical difference
in the parenting psychoeducation of Caring Dads is the continued attention to possible
co-occurring abuse of children’s mothers. In most group-based parenting programs,
there is an implicit assumption that the parents have a nonabusive relationship. Where
parents’ relationships are addressed within the context of parenting interventions,
discussion typically focuses on the need for consistency in parenting or the importance
of communication. The focus of Caring Dads is quite different. In this section of the
program, a repeated theme is that part of good fathering is having a non-abusive,
respectful and supportive coparenting relationship with children’s mothers. One entire
session is devoted to the issue of supporting children’s mothers, but the need to have a
respectful and supportive relationship with her is woven into the vast majority of other
exercises as well (e.g., when the parenting continuum is introduced, having a respectful
relationship with children’s mothers is identified as child-centred). Fathers are
encouraged to consider the lessons they are teaching children through the relationships
they have with their children’s mothers and are explicitly taught how to be more
supportive of all important figures in children’s lives (e.g., mothers, grandparents,
teachers, neighbours).
Avoid teaching disciplinary skills for managing child misbehaviour. An area of
intervention that is prominent with mothers, and that we feel is contraindicated in work
with fathers, is management of child misbehaviour. Although there is a lack of research
addressing the specific question of fathers’ need for discipline training (e.g., learning to
give better instructions, follow-up with consequences, utilize a warning or time-out
system in response to children’s failures to comply) our clinical experience and that of
others suggest that there might be an important difference in interactions of abusive
father-child and mother-child dyads. Among mothers, an important aspect of intervention
is teaching better ways to manage child misbehaviour. Some of the strongest
intervention results have been associated with Parent-Child Interaction Therapy where
mothers are directly coached in being more positive with their children, more effective at
giving directions, and better at following through when children fail to comply (Chaffin et
al., 2004). In our experience, child management is not a core issue for abusive fathers.
We hold this view for a number of reasons.
First, fathers do not generally present with complaints about their children’s
compliance to them – they complain that their children do not listen to their mother.
Fathers describe being on the sidelines of conflict between children and mothers and
occasionally stepping in to “lay down the law”. When fathers do step in, they describe
using authoritative, control-based strategies that generally succeed at gaining immediate
child compliance. In the words of one client, “Oh yeah, I reason with them. If they ask
why they have to do something, I tell them that’s the rules, and that they have to follow
them or else.” Although such strategies are likely to cause problems with compliance
later one – fathers are seldom the ones dealing with these consequences. Instead, they
go back to the sidelines to again complain that their children do not listen to their
mothers.
Second, when fathers do complain about their children’s behaviour, it is usually a
complaint that their children do not accord them the respect and appreciation that they
are due, rather than a complaint about non-compliance. One common example is fathers
complaining that their 13 to 15 year-old children do not appreciate them. Another is the
complaint that their infant or toddler is wary of them during once a week visits because
their mother has turned the child against them. These complaints represent distorted
thinking about children, resulting in part from fathers’ poor understanding and
appreciation of child development. Fathers referred to Caring Dads often lack a good
understanding of their children on which to base judgments. They often cannot talk
Caring Dads Theory May 2010
24
Caring Dads Theory Manual May 2010
about their children’s favourite toys or activities, about things that make them proud, sad,
or afraid, or about their children’s friends, teachers, or schooling. Most importantly,
fathers also often lack an appreciation for their children’s experiences of abuse and fail
to see the links between their children’s current behaviour and their victimization.
Fathers’ lack of appreciation of their children’s victimization forms our third
rational for not teaching child management strategies such as a 1-2-3 warning system,
timeouts, and removal of privileges. Because these fathers lack empathy for their
children’s experiences, they often implement appropriate strategies in inappropriate
ways. An example from our program is a father who duct-taped his child to a chair to get
her to remain in timeout. Furthermore, when fathers have a history of being frightening,
coercive, and abusive, children are likely to react to their attempts to implement a calm
discipline strategy with high levels of anxiety unless this change is preceded by a
significant period of more positive father-child interactions. Finally, because most fathers
who have perpetrated violence in their families have limited insight into difficulties in their
behaviour and low motivation to change, it has been our experience that any focus on
child management can easily degenerate into a discussion of problems with the child
and away from the necessary focus on problems with fathers’ actions. For all of these
reasons, the Caring Dads program has made a specific commitment to avoid teaching
men parenting strategies designed primarily to control child behaviour. Rather, focus is
firmly placed on developing an involved, positive, reinforcing relationship between
fathers and their children.
E. Module 3, Sessions 10-15: To Increase men's awareness of, and responsibility for,
abusive and neglectful fathering and its impact on children.
An interesting contrast occurs at this point in the program. Having completed the first two
modules, fathers are engaged in group, have a good alliance with the group facilitators and with
the other men, and have started to envision and practice more positive and child centred
methods of interacting with their children. Yet, when issues central to their referral arise, fathers
revert to externalizing blame for their actions to their children, children’s mothers or the system,
minimizing impact of their past abuse and relying on parenting that is coercive and/or
unresponsive to children’s needs. Thus, the third module of Caring Dads is devoted to
addressing fathers’ abusive and neglectful behaviour. A major component of the third goal is
individualized cognitive-behavioural analysis of men’s unhealthy, abusive and neglectful
behaviours. Woven into individualized analyses are educational and insight-oriented exercises
to help men identify abuse-supporting cognitions and recognize the effects of abuse on their
children. Although the focus of each client’s change will differ (i.e., some fathers might need to
primarily change behaviour towards their children, others towards their children’s mothers,
though all will address at least one core risk factor for abuse as identified in the review of
literature), the general treatment outcomes expected from this module are for fathers to:
• respond to problems in family relationships without high levels of anger, irritability and
unpredictability
• cooperate respectfully with children’s mothers in making decisions about parenting
• avoid degrading, manipulative, undermining and otherwise hurtful comments or
behaviours to or about children’s mothers
• avoid behaviours that are emotionally or physically abusive, neglectful or otherwise
hurtful to children
• maintain safe use of substances
As mentioned, the core therapeutic strategy used in this module is CBT. At the beginning of
this module, fathers are asked to revisit their goals and, with the help of the group co-facilitators,
to identify changes that will be necessary to meet this goal. These changes will then become
Caring Dads Theory May 2010
25
Caring Dads Theory Manual May 2010
the focus of CBT work over the next 5 sessions. These meetings can occur as part of the group
process, or can be done individually in meetings between fathers and group co-facilitators.
Fathers have a range of goals, and have a variety of intervention needs. Three common
examples are presented below to illustrate the process of moving from fathers’ goals to the use
of CBT.
John’s initial goal: I hope that I can develop a closer bond to my son so that I am someone
he can confide in when he is in trouble.
John’s action plan: If my son is going to feel safe enough to confide in me, I have to stop
blowing up at him whenever I find out that he has been in trouble.
CBT: Used to analyse the thought patterns and distortions that precipitate John’s overreaction to his son’s problematic behaviour. Cognitive restructuring to replace distorted
believes about his son with more positive interpretations and thoughts.
Darcy’s initial goal: I hope that I can have a closer relationship with Sarah and that she will
want to come on visits with her siblings.
Darcy’s action plan: For Sarah to come close to me again, I am going to have to stop
badmouthing her mother.
CBT: Used to analyse the rationalizations allowing Darcy’ to denigrate Sarah’s mother
despite his commitment to the contrary. Thought-stopping strategies taught to eliminate
rumination about Sarah’s mother.
Terrence’s initial goal: I hope that, over time, I can have a relationship with my son (now 16
months and visiting with supervision)
Terrence’s action plan: If I am going to move to more time or to unsupervised visits, I am
going to have to stop missing appointments.
CBT: Used to analyse the antecedents and consequences of Terrence missing visits (ABC
approach) to identify triggers for missed visits or reinforcement received from missing visits.
Collaborative goal setting to change behavioural contingencies.
Once fathers and group co-facilitators jointly set goals for cognitive behavioural work, fathers
are guided to use specific CBT strategies to address problematic cognitions or behaviours.
Fathers complete CBT homework every week and their ongoing progress in meeting change
goals is tracked over the groups.
The use of CBT is supported and recommended for use in addressing criminal
behaviour and child abuse. Several research reviews and meta-analyses in the criminal justice
field assert that CBT is “effective” with violent criminals and criminal populations in general (e.g.
(e.g., Landenberger & Lipsey, 2005; Wilson, Bouffard, & MacKenzie, 2005). The most recent
meta-analysis echoes the conclusion of others: “The evidence summarized in this article
supports the claim that cognitive–behavioural treatment techniques are effective at reducing
criminal behaviours among convicted offenders.” The need for CBT is also supported in
evaluation of batterer intervention (Lehmann & Simmons, 2009). In a recent review, she
concluded that programs for abusive men should go beyond education and skills training, and
should specifically add cognitive-behavioural intervention (Babcock, Greene & Robie, 2004).
Innovators in parenting intervention are exploring the advantages of adding CBT to
traditional interventions, particularly for anxious children (Ha & Oh, 2006, Khanna & Kendall,
2009) and for parents at high risk for abuse (e.g. Azar, 1989). In an important study in this area,
Kolko (1996) randomly assigned participants to CBT, family therapy, or standard community
care. Results showed benefits of both CBT and family therapy conditions over standard care in
the areas of child emotional and behaviour problems family conflict and parental distress;
however CBT was especially helpful for reducing parental anger and the use of physical
punishment. Similar advantages of CBT are noted by Runyon, Deblinger & Schroeder (2009) in
Caring Dads Theory May 2010
26
Caring Dads Theory Manual May 2010
their pilot study of the advantages of adding CBT to group treatment of physically abusive
parents and their children.
F. Module 4, Sessions 16 and 17: Rebuilding trust with children and planning for the
future.
During the final two sessions of the Caring Dads groups, focus is shifted towards issues
around rebuilding trust and planning for the future. The specific treatment outcomes expected
from this module are for fathers to:
• identify specific impacts of their past abuse on children, children’s mothers and on the
mother-child relationship
• hold realistic, child-centred expectations for their continued relationship
As mentioned previously, fathers at this point in the program often want, and expect, to
move quickly to closer relationships with their children. In this module, we address fathers’
impatience in two ways. First, we continue to help fathers understand the impact that their past
abuse has had on their children. Fathers are asked to reflect back on “what it would have taken
for you to forgive your father”, and are continually prompted to view the situation through their
children’s eyes. Second, fathers are specifically educated about the need for the child to set the
pace of healing. They are told that their first goal needs to be the development of a safe and
caring relationship with their children, which includes children feeling safe and supported in their
relationship with their mothers. To reinforce this message, fathers role-play accountability
discussions for practice in being sensitive to children’s abuse experiences. Finally, fathers’
expectations for their relationships are specifically challenged. The group reflects on what men
might realistically hope for given their history of perpetration. If a father is still unsafe for his
child, difficult discussions are initiated about his need to choose to end contact until he can be
safe with his children. Similarly, if children are expressing clear wishes to avoid seeing or talking
to their father, group leaders help men to come to terms with respecting their children’s choice.
Overall, this material is informed and supported by literature on trauma and recovery, and in
particular, on the need for the victim of trauma to set the pace for re-establishing a safe and
healthy relationship (Gil, 2006). The need to ensure child physical and emotional safety in
trauma recovery is emphasized by the vast majority of both directive and non-directive models
of trauma treatment for children and is embedded in recommendation made by the American
Professional Society on the Abuse of Children (APSAC) task force (Chaffin et al., 2006). The
importance of children’s sense of safety has been emphasized in the literature on attachment
and parent-child closeness with the concept of emotional security (Cummings & Davies, 1996).
In this field of study, as well, the importance of safety is emphasized to set the context for
children’s ability to regulate their arousal, develop positive vies of themselves and relate to their
family members (Cummings & Davies, 1996; Davies, Harold, Goeke-Morey, & Cummings,
2002).
SECTION 5: CARING DADS MOTHER CONTACT
In recognition of the considerable overlap between men’s perpetration of child abuse
and domestic violence and due to the intrinsic connection between the safety and well-being of
children and their mothers, Caring Dads also includes a mother contact component. As detailed
in the mother contact manual, all caretaking mothers of men's children are contacted by the
Caring Dads program on a minimum of three occasions, once as soon as possible after men
have begun the program, once midway through his involvement and again at the end of his
treatment. During these contacts, women are provided with information about the program,
referral to support and advocacy services, and if necessary, immediate safety planning. The
over-arching goal of these contacts is to help women through the use of empowering
interventions. Specific treatment outcomes expected are outlined in table 2:
Caring Dads Theory May 2010
27
Caring Dads Theory Manual May 2010
Program
Component
Mother
contact
Intervention
strategies
Empowerment
Treatment needs
addressed
Appreciating the
overlap between
child maltreatment
and domestic
violence
Target Outcomes
As a result of contact, mothers will:
- have numbers and contact
information for services that she
might need
- have been supported in
developing a safety plan, if
necessary
- have information about the Caring
Dads program goals and content
Although the connections between child and mother safety are the rationale for mother
contact, contact itself is guided by theories of empowerment. Empowerment can be defined as
the process of increasing intrapersonal, interpersonal and political power necessary so that
individuals can take action to improve their lives. When working with women who have
experienced abuse, empowerment has been more specifically defined as engaging in the
following activities (Baker & Cunningham, 2004): (a) Respecting confidentiality, (b) Promoting
access to community services, (c) Helping her plan for future safety, (d) Respecting her
autonomy, (e) Believing and validating her experiences, and (f) Acknowledging injustice.
Following this model, mother contact personnel at Caring Dads are charged with the tasks of
listening to and validating women’s experiences, helping her plan for safety and providing her
with information about accessing community resources that might meet her needs. Mother
contact personnel also need to provide women with concrete and detailed information about the
Caring Dads program, its aims and its content. The need to provide women with a realistic
understanding of the outcomes of intervention is another critical aspect of empowerment. Both
qualitative and quantitative studies of domestic violence have found that women’s hope that
men will change, and specifically, his attendance in treatment, is a powerful predictor of
reunification (Gondolf, 1988). It is the task of mother contact to temper that hope with
information about the limitations of Caring Dads and with information about the specific
involvement and progress of her children’s father in the program.
Victim empowerment has always been a central component of efforts to end violence in
relationships (Goodman & Epstein, 2008; Kasturirangan, 2008). In the area of women abuse in
particular, focus has been placed on the empowerment of women to achieve economical, social,
political, legal and educational equity. Such equity is associated with lower rates of violence. In
one of the best studies done in this area, Archer (2006) examined the hypothesis that national
rates of violence would vary depending on broad indicators of women’s empowerment and
equity. Using data across 16 countries, he discovered that women’s rates of victimization were
higher in countries where women had less power. Similarly, there was a positive association
between women's empowerment and acceptance of wife beating. This study provides
convincing evidence in support of the view that women’s empowerment is central to reducing
domestic violence. There is also a large literature base to support the view that individual
empowerment is associated with the adaptive recovery of women who have been abused
(Goodman & Epstein, 2008). For example, Kim et al., (2007) reported on results of a study
where rural African areas were randomly assigned to receive microfinance and educational
intervention. They found that changes in indicators of empowerment, in particular, were
associated with reductions in experiences of domestic violence.
A. Complicating aspects of mother contact
The essential role of the mother contact personal is one of listening, validating and
providing information that might empower women to take steps to change her situation. This
Caring Dads Theory May 2010
28
Caring Dads Theory Manual May 2010
role requires considerable knowledge of the dynamics and typical presentation of domestic
violence, and on the systems that intervene with women who have been abused including
police, civil and criminal courts, supervised access centres, assessment centres, shelters,
advocacy agencies, etc. Mother contact staff also need to be very well informed about local
resources for a large range of problems including challenges in negotiating the legal system,
parenting, coping with the effects of domestic violence, maternal mental health and child
emotional and behavioural difficulties. Finally, the mother contact personnel need to be skilled in
engaging empathetically and respectfully with women have who have been abused.
Mother contact personnel also need clearly differentiate their role as an “empowerer”
rather than as a “helper” or “counsellor”. Fundamentally, the role of mother contact personnel is
to provide women with the information that is going to be most helpful for her to make decisions
about, and act on her situation. Such a role is quite distinct from that of someone who is
counselling women, though there is some overlap particularly in helping women assess and
plan for safety. However, maintaining boundaries in the role of mother contact is often difficult.
Three specific and common situations where it is a challenge to avoid moving into a helper role
are as follows:
Parenting crises. A first challenge for mother contact workers concern parenting crises.
Often, families that are involved in Caring Dads are experiencing major shifts in their family
situations. In addition to any treatment-related changes that might occur, court and child
protection proceedings might mean that fathers have recently left, or re-entered, the home or
have varying visitation schedules. Merely the involvement of social care services can precipitate
crises in some families. In response to these changing circumstances, crises sometimes
(unsurprisingly) arise in parenting. Mother contact personnel, in turn, often feel drawn into
providing crisis intervention, advice and problem-solving. Instead of intervening in this way,
mother contact personnel need to be trained and knowledgeable about appropriate resources.
Mothers might need immediate access to child care, or to temporary relief from parenting.
Children might need immediate intervention to prevent concerning behaviour from escalating,
mothers and children might need immediate intervention to reduce frequent and intense conflict
over their situation. Mother contact should provide direct and immediate empowering assistance
to women in accessing these services.
Complex custody and access situations. There are few issues that are as emotionally
challenging as marital separation, particularly when the separation has been precipitated by
violence. Mothers and fathers accessing Caring Dads services sometimes have very complex
and longstanding difficulties resolving conflicts over custody and access. Women are
sometimes very distressed at the level or nature of contact between fathers and children or
about how fathers are interacting with children during visits. Mother contact personnel need to
have very clear boundaries about the support that they can provide to mothers in these
situations. Concerns about fathers’ behaviours should be documented, and reported when
warranted. However, most often in such cases, the most empowering referral is to a strong legal
advocate who can help women express her concerns more clearly in front of the court.
Situations where mothers feel that their social care worker does not acknowledge
ongoing risk of domestic violence. Finally, situations commonly arise where mothers do not
feel that their social care worker is acknowledging their experience or concerns about violence.
In this situation, mother contact again have a clear role to play in empowering women. Women
can be given information about the process of changing social workers, she might be supported
in arranging a meeting that includes the supervisor for her social care worker and the mother
contact person can assist women in presenting their situation more clearly.
SECTION 6: CARING DADS COORDINATED CASE MANAGEMENT
As outlined in the beginning of this manual, Caring Dads is predicated on a commitment
to work together to ensure child safety and well-being. In this final section of the manual, we
Caring Dads Theory May 2010
29
Caring Dads Theory Manual May 2010
return to consideration of key areas of working together, briefly highlight aspects of practice
connected to these commitments and signpost other manuals where more details on specific
practices are included.
A. Coordinated case management to ensure that priority is given to the safety and wellbeing of children and that Caring Dads is responsive to rising levels of risk.
Following our ideological commitment and extensive research of the especially harmful
impacts of chronic maltreatment, the Caring Dads program places its main priority on achieving
the safety and well-being of children. Fathers who are the target population of the Caring Dads
program have already acted in ways that violate and endanger children, and require
interventions that are able to balance the need to provide help to fathers with a commitment to
ensuring child safety. This stance represents a fundamental shift in focus from most parenting
interventions. Education and treatment programs for parents are most often offered through
child mental health or child and family service agencies whose mission is to support families. In
these agencies, education, support, and skills training are provided to voluntarily attending
clients. Agency personnel readily accept that some parents will choose not to attend
intervention despite relatively high levels of pathology, or will attend but fail to make progress
toward healthier functioning. Family privacy is also protected, in that information is kept
confidential unless the law requires disclosure. Overall, this style of service gives precedence to
parents’ abilities to make decisions they believe will be best for their families and children. When
fathers have been abusive toward members of their family (thereby demonstrating a failure to
make decisions in the best interests of their children), mental health models of service are not
sufficient. Instead, a more prescriptive response is needed that can simultaneously offer
intervention to fathers, monitor their progress in making better parenting decisions, and track
their risk for future abuse perpetration. Interventions for abusive fathers need to accommodate
these changes in priority, aligning more closely with child protection and justice intervention,
incorporating risk assessment and providing clear feedback to referrals. Moreover, although it is
beyond the mandate and capacity of a program like Caring Dads to incapacitate men who
repeatedly maltreat their children, Caring Dads can and should contribute to the collection and
sharing of information across agencies so that the most dangerous fathers can be more
effectively recognized and contained by the justice or child protection systems. Specific
implications for collaborative practice necessary to meet these aims include the need to:
• Jointly assess and monitor changes in men’s risk for violence (see intake and case
management)
• Have a strong model of coordinated case management (see program management
manual)
• Ensure that fathers’ goals align with those of professionals working with children and the
family more generally and monitor fathers’ progress towards ensuring child safety from
their abuse (see program content and program management manual)
• Openly share information with referral agents throughout intervention (see program
management manual)
• Provide evaluative feedback following program completion (see final reports)
• Be willing to have frank and difficult conversations with fathers about limiting their
contact with their children when necessary (see program activities in final section)
B. Coordinated case management to ensure the safety of children’s mothers.
As we have discussed, the problems of domestic violence and fathers’ maltreatment of
children are intertwined. Recognizing this connection between children’s well-being and
mothers’ safety, we explicitly assert that men cannot be good fathers and abusive partners—
that children’s emotional security depends partly on a non-abusive relationship between their
Caring Dads Theory May 2010
30
Caring Dads Theory Manual May 2010
mothers and fathers. Thus, whenever we talk about healthy father-child relationships, we
inevitably talk about men’s relationships with children’s mothers. Our focus on men’s
relationship with children’s mothers represents another difference from traditional parenting
intervention, where there is an assumption of basic physical and emotional safety in the
relationship between mothers and fathers. Commitment to this position requires the following for
coordination:
• Requirement that at least one facilitator with a strong background in women’s advocacy
and a keen appreciation of the dynamics of woman abuse co-facilitates groups (see
facilitator requirements)
• Contact with mothers as one component of intervention (see mother contact manual)
• Close collaboration with a batterer intervention services for cross-referral (see eligibility)
• Evaluation of fathers’ ability to maintain a non-abusive and respectful relationship with
children’s mothers as one component of evaluation (see case management manual)
• Consideration of domestic violence as part of men’s profile of risk (see case
management manual)
• Planning with referral for appropriate services to children’s mothers when fathers have
undermined mothers’ ability to disciple or for other complex situations that may arise
(see case management manual)
C. Coordinated case management to ensure that fathers are engaged in intervention and
compliant with basic treatment demands (i.e., attending, participating)
The Caring Dads program expects that most of the clients who are appropriate for
service will have low motivation for change. As discussed, our intervention strategies with
clients therefore adopt a motivation enhancing approach. However, with professionals, our
approach is different. With professionals, we have taken an “accountability” approach that
emphasizes the need for fathers to contribute to caring for their children. Too often, social
service provides view any willingness of fathers to be involved with their children with great
enthusiasm and positive regard (Featherstone, Hooper, Scourfield & Taylor, 2010; Strega et al.,
2008). As professionals, we need to expect more of fathers and we need to back those
expectations up with mandated involvement with intervention when necessary. Such mandates
send clear messages to fathers that they are responsible for controlling their own behaviours
and for contributing to the care of their children and families. We therefore need to work
together to ensure that fathers are attending intervention to address their risk for maltreating
their children and are complying with basic treatment demands. Other specific aspects of
practice that are informed by this commitment include:
• need for at least one facilitator to be skilled in motivational interviewing and
connecting with men (see program management manual)
• adequate time to conduct intake assessments (see program management manual)
• joint case planning in response to failed referrals (see case management manual)
• joint case planning in response to absences or failures of engagement (see case
management manual)
• strong relationships with referral agents who can actively encourage men to attend
intervention and follow-up with consequences when men fail to comply (see case
management manual)
D. Coordinated case management to ensure that the child is kept in focus
Related to the need to prioritize child safety and well-being is the need to ensure that the
needs of the child are kept in the forefront of intervention with fathers. As discussed previously,
a significant challenge of offering a fathering program is the tendency to drift towards meeting
the needs of fathers, which may or may not be consistent with the needs of children. It is
Caring Dads Theory May 2010
31
Caring Dads Theory Manual May 2010
essential that there is frequent and clear communication between professionals working towards
child safety and well-being and case managers for Caring Dads to ensure that perspectives are
shared. Without such collaboration, there are numerous potential iatrogenic effects of Caring
Dads. For one, fathers may try to use their attendance at a fathering program to manipulate the
system and gain advantage in court proceedings, despite having made no discernable progress.
Fathers may also use program material to harass mothers or to otherwise criticize their
parenting. Protecting against these outcomes requires a number of commitments to
collaborative practice including:
• the need to include a ‘voice’ for the child in case planning (case management
manual)
• focus on program on fathers’ ability to develop safe and predictable relationships
with children (program content)
• feedback in final report on fathers’ appreciation of the impact of his past abuse (case
management manual)
• clear feedback to men and to system partners when fathers are failing to keep
children safe (case management)
• clear communication between the program and referral agents about content of
program (case management)
SECTION 7: CONCLUSION
The Caring Dads program was developed to fill an important gap in services to fathers
who abused or neglected their children or exposed their children to domestic violence. The
program is solidly based on empirical research. Goals are consistent with identified needs of the
population and are using empirically-validated intervention strategies. More research is needed
to determine the efficacy of the Caring Dads program in the UK, particularly in examining the
efficacy of collaborative practice in the longer term. However, the program is sufficiently
developed and promising enough to warrant implementation as a method of ensuring the safety
and well-being of children in the UK.
Caring Dads Theory May 2010
32
Caring Dads Theory Manual May 2010
References
Afifi, T. O., Enns, M. W., Cox, B. J., de Graaf, Ron, ten Have, M., Sareen, J. (2007). Child abuse
and health-related quality of life in adulthood. Journal of Nervous and Mental Disease,
195, 797-804.
Allen, N. E. (2006). An Examination of the Effectiveness of Domestic Violence Coordinating
Councils. Violence Against Women, 12, 343-360.
Allen, S. & Daly, K. (2007). The effects of father involvement: An updated research summary of
the evidence. Guelph ON, Centre for Families, Work & Well-Being, University of Guelph.
Retrieved Aug 8, 2009 from http://www.fira.ca/cms/documents/29/
Effects_of_Father_Involvement.pdf.
Anda, R. F., Dong, M., Brown, D. W., Felitti, V. J., Giles, W. H., Perry, G. S., Edwards, V. J.,
Dube, S. R. (2009). The relationship of adverse childhood experiences to a history of
premature death of family members. BMC Public Health, 9, 106-116.
Archer, J. (2006). Cross-cultural differences in physical aggression between partners: A socialrole analysis. Personality and Social Psychology Review, 10, 133-153.
Australian Government Department of Families, Housing, Community Services and Indigenous
Affairs (FaHCSIA) (2009). Father Inclusive Practice Guide: A tool to support the inclusion
of fathers in a holistic approach to service delivery. Accessed October 20, 2010 from
http://www.fahcsia.gov.au/sa/families/pubs/documents/fatherinclusive/father_inclusive_practice.pdf.
Azar, S. T. (1989). Training parents of abused children. C. E. Schaefer & J. M. Briesmeister
(Eds.). Handbook of parent training: Parents as co-therapists for children's behavior
problems (pp. 414-441). Oxford, England: John Wiley & Sons.
Babcock, J.C., Green, C.E., & Robie, C. (2004). Does batterers’ treatment work? A metaanalytic review of domestic violence treatment. Clinical Psychology Review, 23, 10231053.
Baker, L. & Cunningham, A. (2004). Helping children thrive: Supporting woman abuse survivors
as mothers. Centre for Children and Families in the Justice System. Accessed April 2010
from http://www.lfcc.on.ca/HCT_SWASM.pdf.
Bancroft, L. & Silverman, J. G. (2002). The Batterer as Parent: Assessing the Impact of
Domestic Violence on Family Dynamics. Thousand Oaks, CA: Sage Publications.
Banger, D. M. & Eyberg, S. M. (2003). Father involvement in parent training: When does it
matter? Journal of Clinical Child and Adolescent Psychology, 32, 599-605.
Bennett, L., Stoops, C., Call, C., & Flett, H. (2007). Program completion and re-arrest in a
batterer intervention system. Research on Social Work Practice, 17, 42-54.
Black, D. A., Heyman, R. E. & Slep, A. M. S. (2001). Risk factors for child physical abuse.
Aggression and Violent Behavior, 6, 121-188.
Black, D. A., Slep, A. M. S. & Heyman, R. W. (2001). Risk factors for child psychological abuse.
Aggression and Violent Behavior, 6, 189-201.
Brewster, A. L., Nelson, J. P., Hymel, K. P., Colby, D. R., Lucas, D. R., McCanne, T. R., &
Milner, J. S. (1998). Victim, perpetrator, family, and incident characteristics of 32 infant
maltreatment deaths in the United States Air Force. Child Abuse and Neglect, 20, 573–
587.
Brown, L., Callahan, M. Strega, S. Walmsley, C. & Dominelli, L. (2008). Manufacturing ghost
fathers: The paradox of father presence and absence in child welfare. Child and Family
Social Work, 14, 25-34.
Bugental, D. B., Blue, J., & Cruzcosa, M. (1989). Perceived control over caregiving outcomes:
Implications for child abuse. Developmental Psychology, 25, 532–539.
Caring Dads Theory May 2010
33
Caring Dads Theory Manual May 2010
Bugental, D. B., Brown, M., & Reiss, C. (1996). Cognitive representations of power in caregiving
relationships: Biasing effects on interpersonal interaction and information processing.
Journal of Family Psychology, 10, 397–407.
Bugental, D. B, Ellerson, P. C., Lin, E. K, Rainey, B., Kokotovic, A., & O’Hara, N. (2002). A
cognitive approach to child abuse prevention. Journal of Family Psychology, 16, 243–
258.
Bugental, D. B., & Lewis, J. C. (1999a). The paradoxical misuse of power by those who see
themselves as powerless: How does it happen? Journal of Social Issues, 55, 51–64.
Bugental, D. B., Lewis, J. C., Lin, E., Lyon, J., & Kopeikin, H. (1999b). In charge but not in
control: The management of teaching relationships by adults with low perceived power.
Developmental Psychology, ??, 1367–1378.
Cadsky, O., Hanson, R. K., Crawford, M., & Lalonde, C. (1996). Attrition from a male batterer
treatment program: Client-treatment congruence and lifestyle instability. Violence and
Victims, 11, 51–64.
Cadzow, S. P., Armstrong, K. L. & Fraser, J. A. (1999). Stressed parents with infants:
Reassessing physical abuse risk factors. Child Abuse & Neglect, 23, 845-853.
Canadian Centre for Justice Statistics (2006). Family violence in Canada: A statistical
profile.Catalogue #85-224-X. Ottawa, ON: Statistics Canada. Retrieved August 17, 2009
from http://www.statcan.gc.ca/pub /85-224-x/85-224-x2006000-eng.pdf.
Cavanagh, K., Dobash, R. E, & Dobash, R. P. (2007). The murder of children by fathers in the
context of child abuse. Child Abuse & Neglect, 31, 731–746.
Chaffin, M., Hanson, R. &Saunders, B. E. (2006). "Report of the APSAC Task Force on
attachment therapy, reactive attachment disorder, and attachment problems": Reply to
letters. Child Maltreatment, 11, 381-386.
Chaffin, M., Silovsky, J. F., Funderburk, B., Valle, L. A., Brestan, E. V., Balachova, T., Jackson,
S., Lensgraf, J. & Bonner, B. L. (2004). Parent-child interaction therapy with physically
abusive parents: Efficacy for reducing future abuse reports. Journal of Consulting and
Clinical Psychology, 72, 500-510.
Colby, S. M., Monti, P. M., Barnett, N. P., Rohsenow, D. J., Weissman, K., Spirito, A.,
Lewander, W. J. (1998). Brief motivational interviewing in a hospital setting for
adolescent smoking: A preliminary study. Journal of Consulting and Clinical Psychology,
66, 574−578.
Coohey, C. & Zhang, Y. (2006). The role of men in chronic supervisory neglect. Child
Maltreatment, 11, 27-33.
Crooks, C.V., Scott, K. L., Francis, K., Kelly, T., & Reid, M. (2006). Eliciting change in
maltreating fathers: Goals, processes, and desired outcomes. Cognitive and
Behavioral Practice, 13, 71-81.
Crooks, C. V., Scott, K. L., Wolfe, D. A., Chiodo, D. & Killip, S. (2007). Understanding the link
between childhood maltreatment and violent delinquency: What do schools have to add?
Child Maltreatment, 12, 269-280.
Cunningham, A. & Baker, L. (2004). What about me? Seeking to understand a child’s view of
violence within the family. Centre for Children & Families in the Justice System: London,
Canada.
Cummings, E. M., & Davies, P. (1996). Emotional security as a regulatory process in normal
development and the development of psychopathology. Development and
Psychopathology, 8, 123–139.
Daly, M., & Wilson, M. (2000). Family violence: An evolutionary psychological perspective.
Virginia Journal of Social Policy & the Law, 8, 77–121.
Davis, T. M., Baer, J. S., Saxon, A. J., & Kivlahan, D. R. (2003). Brief motivational feedback
improves post-incarceration treatment contact among veterans with substance use
disorders. Drug and Alcohol Dependence, 69, 197-203.
Caring Dads Theory May 2010
34
Caring Dads Theory Manual May 2010
Davies, P. T., Harold, G. T., Goeke-Morey, M. C., Cummings, E. M., Shelton, K. & Rasi, J. A.
(2002). Child emotional security and interparental conflict. Monographs of the Society for
Research in Child Development, 67, 1–115.
Davies, P. T., Sturge-Apple, M. L. & Cummings, E. M. (2004). Interdependencies among
interparental discord and parenting practices: The role of adult vulnerability and
relationship perturbations. Development and Psychopathology, 16, 773-797.
Dixon, L., Hamilton-Giachristsis, C., Browne, K. & Ostapuik, E. (2007).The co-occurrence of
child and intimate partner maltreatment in the family: Characteristics of the violent
perpetrators. Journal of Family Violence, 22, 675-689.
Douglas, E. M. & Cunningham, J. M. (2008). Recommendations from child fatality review teams:
Results of a US nationwide exploratory study concerning maltreatment fatalities and
social service delivery. Child Abuse Review, 17, 331-351.
Dutton, D. (1996). Jealousy, intimate abusiveness, and intrusiveness. Journal of Family
Violence, 11, 411–423.
Dutton, D. (1998). The abusive personality: Violence and control in intimate relationships. New
York: The Guilford Press.
Eckenrode, J., Ganzel, B., Henderson, C. R., Elliott, S., Olds, D. L., Powers, J., Cole, R.,
Kitzman, H. & Sidora, K. (2000). Preventing child abuse and neglect with a program of
nurse home visitation: The limiting effects of domestic violence. JAMA, 284, 1385-1391.
Eckhardt, C. I., Barbour, K. A. & Davison, G. C. (1998). Articulated thoughts of maritally violent
and nonviolent men during anger arousal. Journal of Consulting and Clinical Psychology,
66, 259-269.
Eckhardt, C. I., Samper, R. E. & Murphy, C. M. (2008). Anger disturbances among perpetrators
of intimate partner violence: Clinical characteristics and outcomes of court-mandated
treatment. Journal of Interpersonal Violence, 23, 1600-1617.
Edleson, J. L. (1999). The overlap between child maltreatment and woman battering. Violence
Against Women, 5, 134-154.
English, D. J., Edleson, J. L. & Herrick, M.E. (2005). Domestic violence in one state’s child
protection caseload: A study of differential case dispositions and outcomes. Children and
Youth Services Review, 27, 1183-1201.
English, D. J., Marshall, D. B., Coghlan, L., Brummel, S. & Orme, M. (1999). Causes and
consequences of the substantiation decision in Washington State Protective Services.
Child & Youth Services Review, 21, 1-23.
English, D. J., Marshall, D. B. & Orme, M. (1999). Characteristics of repeated referrals to child
protective services in Washington State. Child Maltreatment, 4, 297-307
English, D., Wingard, T., Marshall, D.B., Orme, M. & Orme, A. (2000) Alternative responses to
child protective services: Emerging issues and concerns. Child Abuse and Neglect, 23,
375–388.
Evans, S. E., Davies, C., DiLillo, D. (2008). Exposure to domestic violence: A meta-analysis of
child and adolescent outcomes. Aggression and Violent Behavior, 13, 131-140.
Fals-Stewart, W., Golden, J. & Schumacher, J. A. (2003). Intimate partner violence and
substance use: A longitudinal day-to-day examination. Addictive Behaviors, 28, 15551574.
Famularo, R., Stone, K., Barnum, R. & Wharton, R. (1986). Alcoholism and severe child
maltreatment. American Journal of Orthopsychiatry, 56, 481-485.
Featherstone, B., Hooper, C-A., Scourfield, J. and Taylor, J. (eds.) (2010) Gender and Child
Welfare in Society, Oxford, Wiley-Blackwell.
Feinberg, M. E., Kan, M. L. & Hetherington, E. M. (2007). The longitudinal influence of
coparenting conflict on parental negativity and adolescent maladjustment. Journal of
Marriage and Family, 69, 687-702.
Caring Dads Theory May 2010
35
Caring Dads Theory Manual May 2010
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A.M., Edwards, V., Koss, M.
P., & Marks, J.S. (1998). Relationship of childhood abuse and household dysfunction to
many of the leading causes of death in adults: The adverse childhood experiences (ACE)
study. American Journal of Preventive Medicine, 14, 245-258.
Foran, H. M. & O’Leary, K. D. (2008). Alcohol and intimate partner violence: A meta-analytic
review. Clinical Psychology Review, 28, 1222-1234.
Forrester, D. (2007). Patterns of re-referral to social services: a study of 400 closed cases. Child
and Family Social Work, 12, 11–21.
Forrester, D. & Harwin, J. (2008). Parental substance misuse and child welfare: Outcomes for
children two years after referral. British Journal of Social Work, 38, 1518-1535.
Francis, K. J. & Wolfe, D. A. (2008). Cognitive and emotional differences between abusive and
non-abusive fathers. Child Abuse & Neglect, 32, 1127-1137.
Freedman, S. R. (1998). Forgiveness and reconciliation: The importance of understanding how
they differ. Counseling and Values, 42, 200–216.
Gil, E. (2006). Helping abused and traumatized children: Integrating directive and nondirective
approaches. New York: Guilford Press.
Goodman, L. A. & Epstein, D. (2008). Listening to battered women: A survivor-centered
approach to advocacy, mental health, and justice. Washington, DC: American
Psychological Association.
Gondolf, E. W. (1988). The effect of batterer counseling on shelter outcome. Journal of
Interpersonal Violence, 3, 275-289.
Gondolf, E. (2001). Batterer intervention systems: Issues, outcomes and recommendations.
Thousand Oaks, CA: Sage.
Ha, E. H. & Oh, K. J. (2006). Effects of cognitive-behavioral group therapy for depressive
mothers of children with behavior problems. Child & Family Behavior Therapy, 28, 1-13.
Harwin, J., Owen, M., Locke, R. & Forrester, D. (2003) Making Care Orders Work, The
Stationery Office: London, UK.
Herman, J. (1992). Trauma and recovery: The aftermath of violence—from domestic abuse to
political terror. New York: Basic Books.
Holtzworth-Munroe, A. & Hutchinson, G. (1993). Attributing negative intent to wife behavior: The
attributions of maritally violent versus nonviolent men. Journal of Abnormal Psychology,
102, 206-211.
Horvath, A. O., & Symonds, B. D. (1991). Relation between working alliance and outcome in
psychotherapy: A meta-analysis. Journal of Counselling Psychology, 38, 139-149.
Jin, X., Eagle, M. & Keat, J. E. (2008). Hostile attributional bias, early abuse, and social
desirability in reporting hostile attributions among Chinese immigrant batterers and
nonviolent men. Violence and Victims, 23, 773-786.
Jones, A. S. & Gondolf, E. W. (2001). Time-varying risk factors for reassault among batterer
program participants. Journal of Family Violence, 16, 345-359.
Kasturiragan, A. (2008). Empowerment and programs designed to address domestic violence.
Violence Against Women, 14, 1465-1475.
Katz, L. F. & Low, S. M. (2004). Marital violence, co-parenting, and family-level processes in
relation to children's adjustment. Journal of Family Psychology, 18, 372-382.
Khanna, M. S. & Kendall, P. C. (2009). Exploring the role of parent training in the treatment of
childhood anxiety. Journal of Consulting and Clinical Psychology, 77, 981-986.
Kim, J. C., Watts, C. H., Hargreaves, J. R., Ndhlovu, L. X., Phetla, G., Morison, L. A., Busza, J.,
Porter, J. D. H. & Pronyk, P. (2007). Understanding the impact of a microfinance-based
intervention on women's empowerment and the reduction of intimate partner violence in
South Africa. American Journal of Public Health, 97, 1794-1802.
Kistenmacher, B. R. (2001). Motivational interviewing as a mechanism for change in men who
batter: A randomized controlled trial. Dissertation Abstracts International, 61(9-B), 4989.
Caring Dads Theory May 2010
36
Caring Dads Theory Manual May 2010
Kitzmann, K. M., Gaylord, N. K., Holt, A. R., Kenny, E. D. (2003). Child witnesses to domestic
violence: A meta-analytic review. Journal of Consulting and Clinical Psychology, 71, 339352.
Klein, A. R. & Tobin, T. (2008). A longitudinal study of arrested batterers, 1995-2005: Career
criminals. Violence Against Women, 14, 136-157.
Klevens, J. & Leeb, R. T. (2010). Child maltreatment fatalities in children under 5: Findings from
the national violence death reporting system. Child Abuse & Neglect, 34, 262-266.
Krug, E. G., Dahlberg, L. L., Mercy, J. A., Zwi, A. B. & Lozano, R. (Eds). (2002). World report on
violence and health. World Health Organization: Geneva.
Landerberger, N. A. & Lipsey, M. W. (2005). The positive effects of cognitive-behavioral
programs for offenders: A meta-analysis of factors associated with effective treatment.
Journal of Experimental Criminology, 1, 451-476.
Lee, S., Guterman, N. B. & Lee, Y. (2008). Risk factors for paternal physical child abuse. Child
Abuse & Neglect, 32, 846-858.
Lehmann, P. & Simmons, C. A. (Eds) (2009). Strengths-based batterer intervention: A new
paradigm in ending family violence. Thousand Oaks, CA: Sage Publications.
Lengua, L., Roose, M. W., Schupak-Neuberg, E., Michaels, M. L., Berg, C. N & Weschler, L. F.
(1992). Using focus groups to guide the development of a parenting for difficult-to-reach,
high-risk families. Family Relations, 41, 163-168
Lundahl, B. W., Nimer, J. & Parsons, B. (2006). Preventing child abuse: A meta-analysis of
parent training programs. Research on Social Work Practice, 16, 251-262.
Mammen, O. K., Kolko, D. J. & Pilkonis, P. A. (2002). Negative affect and parental aggression in
child physical abuse. Child Abuse & Neglect, 26, 407-424.
MacLeod, J., & Nelson, G. (2000). Programs for the promotion of family wellness and the
prevention of child maltreatment: A meta-analytic review. Child Abuse & Neglect, 24,
1127-1149.
MacMillan, H., Fleming, J., Trocmé, N., Boyle, M., Wong, M., Racine, Y., Beardslee, W., &
Offord, D. (1997). Prevalence of child physical and sexual abuse in a community
sample:Results from the Ontario health supplement. Journal of the American Academy of
Medicine, 278,131–135.
Maneesakorn, S., Robson, D., Gournay, K., & Gray, R. (2007). An RCT of adherence therapy
for people with schizophrenia in Chiang Mai, Thailand. Journal of Clinical Nursing, 16,
1302-1312.
Marshall, D. B., English, D. J., & Stewart, A. J. (2001). The effect of fathers or father figures on
child behavioral problems in families referred to child protective services. Child
maltreatment, 6, 290-299.
Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with
outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical
Psychology, 68, 438-450.
McKinney, C. M., Caetano, R., Harris, T. R. & Ebama, M. S. (2009). Alcohol availability and
intimate partner violence among US couples. Alcoholism: Clinical and Experimental
Research, 33, 169-176.
McKinnon, M., Davies, L., & Rains, P. (2001). Taking account of men in the lives of teenage
mothers. Affilia 16, 80-99.
Mignone, T., Klostermann, K. & Chen, R. (2009). The relationship between relapse to alcohol
and relapse to violence. Journal of Family Violence, 24, 497-505.
Miller, W.R., & Rollnick, S. (2002). Motivational Interviewing: Preparing people of change. New
York, NY: Guildford Press.
Monti, P. M., Colby, S. M., Barnett, N. P., Spirito, A., Rohsenow, D. J., Myers, M., & Lewander,
W. (1999). Brief intervention for harm reduction with alcohol-positive older adolescents in
Caring Dads Theory May 2010
37
Caring Dads Theory Manual May 2010
a hospital emergency department. Journal of Consulting and Clinical Psychology, 67,
989−994.
Moretti, M. M., Holland, R., Moore, K., & McKay, S. (2004). An attachment based parenting
program for caregivers of severely conduct disordered adolescents: Preliminary findings.
Journal of Child and Youth Care Work, 19, 170-178.
Morrill, M. I., Hines, D. A., Mahmood, S. & Cordova, J. V. (2010). Pathways between marriage
and parenting for wives and husbands: The role of coparenting. Family Process, 49, 5973.
Mullender, A., Hague, G., Imam, U., Kelly, L., Malos, E. & Regan, L. (2002). Children’s
Perspectives on Domestic Violence. London: Sage.
Murphy, C. M., & Baxter, V. A. (1997). Motivating batterers to change in the treatment context.
Journal of Interpersonal Violence, 12, 607–619.
Murphy, C. M., Taft, C. T. & Eckhardt, C. I. (2007). Anger problem profiles among partner
violent men: Differences in clinical presentation and treatment outcome. Journal of
Counseling Psychology, 54, 189-200.
National Commission of Inquiry into the Prevention of Child Abuse (1996) Childhood matters,
Vols 1 and 2. London: NSPCC.
Newberger, C. M. & White, K. M. (1989). Cognitive foundations for parental care. In D. Cicchetti
& V. Carlson (Eds.). Child maltreatment: Theory and research on the causes and
consequences of child abuse and neglect. (pp. 302-316). New York, NY: Cambridge
University Press.
Norlander, B. & Eckhardt, C. (2005). Anger, hostility, and male perpetrators of intimate partner
violence: A meta-analytic review. Clinical Psychology Review, 25, 119-152.
O’Leary, K. D., Slep, A. M. & O’Leary, S. G. (2007). Multivariate models of men's and women's
partner aggression. Journal of Consulting and Clinical Psychology, 75, 752-764.
Palm, G. & Fagan, J. (2008). Father involvement in early childhood programs: Review of the
literature. Early Child Development and Care, 178, 745-759.
Peled, E. (2000). Parenting by men who abuse women: Issues and dilemmas. British Journal of
Social Work, 30, 25–36.
Pennington-Zoellner, K. (2009). Expanding ‘community’ in the community response to intimate
partner violence. Journal of Family Violence, 24, 539-545.
Perel, G. & Peled, E. (2008). The fathering of violent men: Constriction and yearning. Violence
Against Women, 14, 457-482.
Perez-Albeniz, A. & de Paul, J. (2004). Gender differences in empathy in parents at high- and
low-risk of child physical abuse. Child Abuse & Neglect, 28, 289-300.
Perry, M. A., Wells, E. A. & Doran, L. D. (1983). Parent characteristics in abusing and
nonabusing families. Journal of Clinical Child Psychology, 12, 329-336.
Pittman, J. F. & Buckley, R. R. (2006). Comparing maltreating fathers and mothers in terms of
personal distress, interpersonal functioning, and perceptions of family climate. Child
Abuse & Neglect, 30, 481-496.
Powell, C. (2003). Early indicators of child abuse and neglect: A multi-professional Delphi study.
Child Abuse Review, 12, 25-40.
Prochaska, J., & DiClemente, C. (1982). Transtheoretical therapy: Toward a more integrative
model of change. Psychotherapy: Theory, Research and Practice, 19, 276–288.
Prochaska, J. O., DiClemente, C. C. & Norcross, J. C. (1992). In search of how people change:
Applications to addictive behaviors. American Psychologist, 47, 1102-1114.
Radhakrishna, A., Bou-Saada, I., Hunter, W., Catellier, D., & Kotch, J. (2001). Are father
surrogates a risk factor for child maltreatment? Child Maltreatment, 6, 281–289.
Raikes, H. H., & Bellotti, J. (2006). Two studies of father involvement in Early Head Start
programs: A practitioners' survey and a demonstration program evaluation. Parenting
Science and Practice, Special Issue Early Head Start Fathers and Children, 6, 229-243.
Caring Dads Theory May 2010
38
Caring Dads Theory Manual May 2010
Rimm-Kaufman, S. E. & Zhang, Y. (2005). Father-school communication in preschool and
kindergarten. School Psychology Review, 34, 287-308.
Risley-Curtiss, C. & Heffernan, K. (2003). Gender biases in child welfare. Affilia, 18, 395-410.
Runyon, M. K., Deblinger, E. & Schroeder, C. M. (2009). Pilot evaluation of outcomes of
combined parent-child cognitive-behavioral group therapy for families at risk for child
physical abuse. Cognitive and Behavioral Practice, 16, 101-118.
Safeguarding Children: The third joint Chief Inspectors’ report on arrangements to safeguard
children (2008). Alexandra House: London.
Sandberg, J.F. & Hofferth, S.L. (2001). Changes in children’s time with parents: United States,
1981–1997. Demography, 38, 423–436.
Schaeffer, C. M., Alexander, P. C., Bethke, K. & Kretz, L. S. (2005). Predictors of child abuse
potential among military parents: Comparing mothers and fathers. Journal of Family
Violence, 20, 123-129.
Schumacher, J. A., Feldbau-Kohn, S., Slep, A. M. S. & Heyman, R. E. (2001). Risk factors for
male-to-female partner physical abuse. Aggression and Violent Behavior, 6, 281-352.
Schumacher, J. A., Homish, G. G., Leonard, K. E., Quigley, B. M. & Kearns-Bodkin, J. N.
(2008). Longitudinal moderators of the relationship between excessive drinking and
intimate partner violence in the early years of marriage. Journal of Family Psychology,
22, 894-904.
Scourfield, J. (2003) Gender and Child Protection, London, Palgrave Macmillan.
Scott, K .L. & Crooks, C. V. (2004). Effecting change in maltreating fathers. Clinical
Psychology: Science & Practice, 11, 95-111.
Scott, K. L. & Crooks, C. V. (2006). Intervention for abusive fathers: Promising practices in court
and community responses. Juvenile and Family Court Journal, 57, 29-44.
Scott, K. L. & Crooks, C. V. (2007). Preliminary evaluation of an intervention program for
maltreating fathers. Brief Treatment and Crisis Intervention, 7, 224-238.
Scott, K., Francis, K., Crooks, C., & Kelly, T. (2006). Caring Dads: Helping fathers value their
children. Victoria, BC: Trafford Publishing.
Scott, K. L., King, C. McGinn, H. & Hosseini, N. (in press). Effects of Motivational Enhancement
on Immediate Outcomes of Batterer Intervention. Journal of Family Violence.
Scott, K. L., & Wolfe, D. A. (2003). Readiness to change as a predictor of outcome in batterer
treatment. Journal of Consulting and Clinical Psychology, 71, 879–889.
Silber, S., Bermann, E., Henderson, M. & Lehman, A. (1993). Patterns of influence and
response in abusing and nonabusing families. Journal of Family Violence, 8, 27-38.
Sinclair, I., Baker, C., Wilson, K. & Gibbs, I. (2005) Foster Children: Where They Go and How
They Get On, Jessica Kingsley: London, UK.
Skowron, E. & Reinemann, D. H. (2005). Effectiveness of psychological interventions for child
maltreatment: A meta-analysis. Psychotherapy: Theory, Research, Practice, Training, 42,
52-71.
Slep, A. M. & O’Leary, S. G. (2001). Examining partner and child abuse: Are we ready for a
more integrated approach to family violence? Clinical Child and Family Psychology
Review, 4, 87-107.
Stith, S. M., Lui, T., Davies, C., Boykin, E. L., Alder, M. C., Harris, J. M, Som, A., McPherson, M.
& Dees, J. (2009). Risk factors in child maltreatment: A meta-analytic review of the
literature. Aggression and Violent Behavior, 14, 13-29.
Strega, S., Fleet, C., Brown, L., Dominelli, L., Callahan, M. & Walmsley, C. (2008). Connecting
father absence and mother blame in child welfare policies and practice. Children and
Youth Services Review, 30, 705-716.
Strega, S., Brown, L., Dominelli, L., Walmsley, C. and Callahan, M. (2009). Working with me,
working at me: Narratives of fathers in child welfare. Journal of Progressive Human
Services, 20, 72-91.
Caring Dads Theory May 2010
39
Caring Dads Theory Manual May 2010
Stein, L. A. R., Colby, S. M., Barnett, N. P., Monti, P. M., Golembeske, C., & Lebeau-Craven, R.
(2006). Effects of motivational interviewing for incarcerated adolescents on driving under
the influence after release. American Journal on Addictions, 15, 50-57.
Stephens, R. S., Roffman, R. A., & Curtin, L. (2000) Comparison of extended versus brief
treatments for marijuana use. Journal of Consulting and Clinical Psychology, 68, 898–
908.
Stewart, L., Usher, A. & Allenby, K. (2009). A review of optimal group size and modularisation or
continuous entry format for program delivery. Correctional Service Canada. Accessed
November 1, 2011 from http://www.csc-scc.gc.ca/text/rsrch/ reports/r215/r215-eng.shtml
Stosny, S. (1994). “Shadows of the heart”: A dramatic video for the treatment resistance of
spouse abusers. Social Work, 39, 686–694.
Stotts, A. M., Schmitz, J. M., Rhoades, H. M., & Grabowski, J. (2001). Motivational interviewing
with cocaine-dependent patients: A pilot study. Journal of Consulting and Clinical
Psychology, 69, 858-862.
Taft, C. T., Murphy, C. M., Elliott, J. D., & Morrel, T. M. (2001). Attendance-enhancing
procedures in group counseling for domestic abusers. Journal of Counseling Psychology,
48, 51–60.
Thompson, R. & Wiley, T. R. (2009). Predictors of re-referral to child protective services: A
longitudinal follow-up of an urban cohort maltreated as infants. Child Maltreatment, 14,
89-99.
Tolman, R. M., & Bhosley, G. (1990). A comparison of two types of pregroup preparation for
men who batter. Journal of Social Service Research, 13, 33-43.
Tonizzo, S., Howells, K., Day, A., Reidpath, D. & Froyland, I. (2000). Attributions of negative
partner behavior by men who physically abuse their partners. Journal of Family Violence,
15, 155-167.
Trocmé, N., Fallon, B., MacLaurin, B., Daciuk, J., Felstiner, C., Black, T., et al. (2005).Canadian
Incidence Study of Reported Child Abuse and Neglect – 2003: Major Findings. Ottawa,
ON: Minister of Public Works and Government Services Canada.
Straus, M. A., & Gelles, R. J. (Eds.). (1990). Physical violence in American families: Risk factors
and adaptations to violence in 8,145 families. New Brunswick, NJ: Transactions.
U.S. Department of Health and Human Services (2005). Male perpetrators of child
maltreatment: Findings from NCANDS. Downloaded from
http://aspe.hhs.gov/hsp/05/child-maltreat/report.pdf. October 20, 2010.
van der Kolk, B., & McFarlane, A. (1996). The black hole of trauma. In et al. (Ed.), Traumatic
stress: The effects of overwhelming experience on mind, body, and society (pp. 2–23).
New York: Guilford Press.
Wallach, H. S. & Sela, T. (2008). The importance of male batters' attributions in understanding
and preventing domestic violence. Journal of Family Violence, 23, 655-660.
Walmsley, C. (2009). Fathers and the Child Welfare System. A report to the Federation of Child
and Family Services of B.C. Research and Practice Network. Retrieved Aug. 28, 2009
from http://www.fcfs.bc.ca/uploads/FathersandtheChildWelfareSystemMar09.pdf
Wekerle, C., & Wolfe, D. A. (2003). Child maltreatment. In E. J. Mash & R. A. Barkley
(Eds).Child Psychopathology, 2nd edition (pp. 632-684). New York: Guilford Press.
Whipple, E. E. & Webster-Stratton, C. (1991). The role of parental stress in physically abusive
families. Child Abuse & Neglect, 15, 279-291.
Wiehe, V. R. (2003). Empathy and narcissism in a sample of child abuse perpetrators and a
comparison sample of foster parents. Child Abuse & Neglect, 27, 541-555.
Wilson, D. B., Bouffard, L. A. & Mackenzie, D. L. (2005). A quantitative review of structured,
group-oriented, cognitive-behavioral programs for offenders. Criminal Justice and
Behavior, 32, 172-204.
Caring Dads Theory May 2010
40
Caring Dads Theory Manual May 2010
Wilson, S. R., Rack, J. J., Shi, X. & Norris, A. M. (2008). Comparing physically abusive,
neglectful, and non-maltreating parents during interactions with their children: A metaanalysis of observational studies. Child Abuse & Neglect. 32, 897-911.
Wolfe, D. A. (1999). Child Abuse: Implications for child development and psychopathology
(second edition). Sage Publications: Thousand Oaks, CA.
Wolfe, D. A., Crooks, C. V., Lee, V., McIntyre-Smith, A., Jaffe, P. (2003). The effects of
children's exposure to domestic violence: A meta-analysis and critique. Clinical Child and
Family Psychology Review, 6, 171-187.
Wolfe, D. A., Scott, K., Wekerke, C., & Pittman, A. (2001). Child maltreatment: Risk of
adjustment problems and dating violence in adolescence. Journal of the American
Academy of Child and Adolescent Psychiatry, 40, 282-289.
Wulfert, E., Blanchard, E. B., Freidenberg, B. M., & Martell, R. S. (2006). Retaining pathological
gamblers in cognitive behavior therapy through motivational enhancement – a pilot study.
Behavior Modification, 30, 315–340.
Yalom, I. D. (1970). The Theory and Practice of Group Psychotherapy, New York, NY: Basic
Books.
Yampolskaya, S., Greenbaum, P. E. & Berson, I. R. (2009). Profiles of child maltreatment
perpetrators and risk for fatal assault: A latent class analysis.
Journal of Family Violence, 24, 337-348.
Young, N. K., Boles, S. M. & Otero, C. (2007). Parental substance use disorders and child
maltreatment: Overlap, gaps, and opportunities. Child Maltreatment, 12, 137-149.
Caring Dads Theory May 2010
41